| NPI | 1891060398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GODFREY FONDINKA Medical Director 910-425-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: NC 200301461) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200301461) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2021-05-26 |