| NPI | 1598717381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE D BLANKENSHIP Credentialing Coordinator 256-739-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-06-15 |