| NPI | 1992254213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R STOVER Nurse Practitioner 704-923-2028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 5008798) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |