| NPI | 1174718464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT HULL BOSWELL President/Owner 205-302-0284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: AL 16975) |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine (Licence: AL 16975) |
| 207QA0401X Family Medicine Addiction Medicine (Licence: AL 16975) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |