| NPI | 1548724297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REMONA L PETERSON Owner 205-764-5162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-05-15 |