| NPI | 1588402341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY HODGES Office Manager 251-447-3192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-12-12 |