| NPI | 1902869043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDI DAVIS Manager 919-954-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 24304) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 1226) |
| 111N00000X Chiropractor (Licence: NC 2806) | |
| 207Q00000X Family Medicine (Licence: NC 26547) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2010-01-12 |