| NPI | 1568949097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENATA HOLLIMAN Manager 251-422-1979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MS 1127426) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |