| NPI | 1972983286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA R KEATES Owner 919-400-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 3960) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-08-13 |