| NPI | 1255481677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLECYA YVETTE CHEATHAM President 334-807-0235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00019306) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-01-23 |