| NPI | 1881083962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA WILKINS PARNELL Credentialing Specalist 910-737-3147 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |