| NPI | 1750799524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA THOMAS Officer/Owner 251-621-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: AL 29849) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |