| NPI | 1215385372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY SATIAGO Manager 256-508-9034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: MD R187947) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |