| NPI | 1871018242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALLRED Owner 336-509-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2017-08-07 |