NPI | 1467639534 |
---|---|
Entity Type | Organization |
Authorized Contact | WESLEY C CROWELL Owner/President 256-233-0712 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AL 25244) |
Enumeration Date | 2008-01-30 |
Last Update Date | 2008-01-30 |