| NPI | 1912340944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITTIE CANADY ELLIOTT Operations Manager 910-323-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy (Licence: NC ASO123) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NC ASO123) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2018-05-30 |