| NPI | 1285841577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A WOOD Manager 334-319-3279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: AL 1-066975) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |