| NPI | 1871800177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI REAGAN Director 336-753-6155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics Child Abuse Pediatrics |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2023-05-02 |