| NPI | 1336800010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMMY LYN BEALL Owner 251-377-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-06-21 |