| NPI | 1518625888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA LATONYA HUNT Nurse Practitioner 424-494-7905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2025-05-02 |