| NPI | 1508389016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK HUBLER Director 256-973-2802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1-10334) |
| 208000000X Pediatrics (Licence: AL 35949) | |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-07-21 |