| NPI | 1912293994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANYE GRAHAM Owner/Clinic Director 910-823-4879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 4038) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |