| NPI | 1952929218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN HODGE Authorized Official 252-702-5245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |