| NPI | 1003656919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WADE PRINCE Co Owner 256-612-0173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2025-10-29 |