| NPI | 1922256254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROC LANE PRATT President 704-541-7654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 77796) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: NC 77796) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2010-03-11 |