| NPI | 1568915106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUEY R KIDD Physician 334-636-5311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2019-01-08 |