| NPI | 1346612421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARGARET DUPPER President 256-340-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 20222) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: AL 158) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2024-07-01 |