| NPI | 1528727179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK BROWN Authorized Official 256-734-3146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2022-06-24 |