| NPI | 1043782675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILLIE ELIZABETH MARTIN Practice Manager 256-907-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2020-11-01 |