| NPI | 1427255413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE GADD STANLEY Physician 256-766-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AL 9564) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-22 |