| NPI | 1952531642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRYAN COOPER Owner 252-215-3067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NC 200400320) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: NC 200400320) |
| 2085N0700X Radiology Neuroradiology (Licence: NC 200400320) | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2010-03-11 |