| NPI | 1952543688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMIE M WAYNICK Controller 336-633-0413 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 9700286) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2009-09-01 |