| NPI | 1134907439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JOHANSEN President 205-421-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-04-09 |