| NPI | 1538540729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KALISZAK D.O. 256-325-1160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: AL DO882) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |