| NPI | 1770118655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK BOWLING Md/Owner 205-388-8863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |