| NPI | 1205977089 |
|---|---|
| Former Legal Business Name | PEDIATRIC CLINIC |
| Entity Type | Organization |
| Authorized Contact | DAVID BRYANT SMALLEY Officer 334-749-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |