| NPI | 1760915748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN B COOPER Manager 334-298-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: AL DO929) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2019-07-20 |