| NPI | 1669231676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA LONG Owner 251-554-6288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |