| NPI | 1164891248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WILCOX Physician/Manager 334-730-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AL 150982) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-09-18 |