| NPI | 1336634666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY THOMAS RUTHERFORD CFO Office Mgr 256-233-0712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-07-11 |