| NPI | 1770782849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA WYATT Physician/President 256-353-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2025-08-21 |