| NPI | 1144836446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA SMITH Mbr 256-677-3295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-12-07 |