| NPI | 1023007325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY JAN DAVIS Owner/President 256-882-0132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00004217) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2020-08-22 |