| NPI | 1316014681 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | MARQUIS HESTER Insurance 205-349-0049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-10-03 |