NPI | 1114141744 |
---|---|
Doing Business As | HERITAGE FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | ANTHONY G MANCUSO CFO 256-990-8446 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00015990) |
Enumeration Date | 2007-04-13 |
Last Update Date | 2018-12-07 |