| NPI | 1306049580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADISESHA REDDY Owner Provider 205-345-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: AL U6302) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2008-04-03 |