| NPI | 1346986015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIZ JUAN Owner 256-979-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 363LA2100X Nurse Practitioner, Acute Care | |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2024-10-16 |