| NPI | 1033303367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA NEWBERN THOMAS Owner 256-237-0215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 11263) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1082088) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |