| NPI | 1003150160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HARRELL WARD President 251-981-2420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AL 20122108) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |