| NPI | 1780043075 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP-FOLEY |
| Entity Type | Organization |
| Authorized Contact | TODD KENNEDY President 251-633-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |