| NPI | 1356732630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILDA STEPHENSON Manager 205-965-2397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 12767) |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2015-02-09 |