| NPI | 1013202951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRY SMITH Coordinator For Mhicm Programs 205-933-8101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: AL 2732G) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-17 |