| NPI | 1659939270 |
|---|---|
| Doing Business As | USA STANTON ROAD CLINIC |
| Entity Type | Organization |
| Authorized Contact | GLEN OWEN BAILEY CEO 251-471-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |