| NPI | 1982905832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEVITA DENISE TERRY Owner 252-210-3457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 120969) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |