| NPI | 1972476695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEGAN DUNN Owner 336-862-4814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-10-13 |