| NPI | 1528951290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY CLARK Medical Director/Owner 334-538-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-06-02 |