| NPI | 1659487411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY CHILDRESS Coder/Biller 256-259-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 00026295) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2008-06-17 |