| 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 |