| NPI | 1306840871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R FELLOWS Owner 228-388-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: MS 08239) |
| Enumeration Date | 2005-06-11 |
| Last Update Date | 2008-09-10 |