NPI | 1265210645 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY JOHANSEN President 205-421-2101 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2023-09-18 |
Last Update Date | 2024-04-24 |