| NPI | 1962163402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE FLEETWOOD STEPHENSON President 252-395-2327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-06 |