| NPI | 1275774721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MAE BLUMER CORCORAN CEO 251-281-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AL 27491) |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2009-03-13 |