| NPI | 1881623023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN ASHLEY WITHROW Medical Director 919-968-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC 27884) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2013-02-27 |