| NPI | 1205893732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANETTE KEENER Billing Manager 256-547-6331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2011-08-17 |