| NPI | 1972523470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID STADIEM Owner 919-851-3292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NC 23233) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2009-09-03 |