| NPI | 1336499680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA BRYAN PYNES Office Manager/Part Owner 334-791-2708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MT 12763) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2023-03-07 |