| NPI | 1801203369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHANNAD FADL AZZAM Medical Director 334-414-2936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2024-06-28 |