| NPI | 1659670594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE CHAICHARNCHEEP Medical Provider 205-910-5356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: AL 26967) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2022-08-23 |