| NPI | 1871795625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE HOLLENSWORTH President 251-433-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: AL 00005635) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |