| NPI | 1245779529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JOHANSEN President 205-403-8902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X (Licence: AL 1-138779) |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2024-04-24 |