| NPI | 1750094744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA OSBORNE Member 256-558-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-08-24 |