| NPI | 1477129476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS VAN RAAM COO 205-703-6760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2025-03-25 |