| NPI | 1710116066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL POTTER Owner 256-331-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-072201) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-11-24 |