| NPI | 1356849566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA ALLEN WHITE Physician/Owner 618-659-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036121823) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-02-16 |