| NPI | 1558631176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA BEVERLY DURAND-MITCHELLE Owner/Physician 251-368-5117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 25566) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-03-13 |