| NPI | 1639539455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON R PATTEN Owner 334-717-1073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NC 2014-01121) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |