| NPI | 1902043185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY BROADNAX Office Manager 704-544-6533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |