| NPI | 1477830768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN FARMER Office Manager 256-533-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AL 5685) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |