| NPI | 1679364715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY J BOLUS VP Clinical Services 205-424-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2025-05-16 |