| NPI | 1609209253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH S JACOBS Managing Member 256-929-3918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AL 2227) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2022-11-03 |