| NPI | 1811775299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JOHANSEN President 205-421-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2025-03-27 |