| NPI | 1841662020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY DALTON GOODWIN Owner/ Sole Member Of LLC 256-547-0433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 24747) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2016-02-24 |