| NPI | 1972905644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OKYERE BONNA Administrator 704-526-9052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 5007063) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |