| NPI | 1861018111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY WELLS President 501-202-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |