| NPI | 1467576801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE O WEATHERLY Management Consultant 256-734-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |