| NPI | 1881904365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2021-10-07 |