| NPI | 1881619740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZI M ROS Office Manager 910-937-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 200200443) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-10-30 |