| NPI | 1417204686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILHELM TIETKE Physician/Owner 256-880-9628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 7067) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |