| NPI | 1366565152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BRUCE CEO 334-567-4311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: AL 22736) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2012-10-01 |