| NPI | 1740493436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYLA SHA-VON JOHNSON Com PT Roller 256-350-1458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-037625) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2025-08-01 |