| NPI | 1912237306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA L FREELEY Nc Billing System Supervisor 704-344-0491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC pending) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2018-12-04 |