| NPI | 1508428442 |
|---|---|
| Doing Business As | SOUTHWELL SCHOOL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DORMAN President/CEO 229-353-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LS0200X Nurse Practitioner, School |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2022-06-24 |