| NPI | 1972944007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONETTA GRAHAM Director 919-217-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |