| NPI | 1124757588 |
|---|---|
| Doing Business As | GREAT STATE RURAL CLINICS |
| Doing Business As | GREAT STATE ALABAMA |
| Entity Type | Organization |
| Authorized Contact | DANIEL SPARKMAN Executive Director 205-509-9055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-06-09 |