| NPI | 1922612662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SCHEUTZOW Owner 336-653-9115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |