| NPI | 1952826323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLTON OWENSBY Member 704-912-1725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 29362) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2017-09-26 |