| NPI | 1942489695 |
|---|---|
| Doing Business As | CLUB HAVEN FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | LEWIS S THORP President/CEO 336-721-3900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2008-04-10 |