| NPI | 1871615997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA M GUNNELS Office Manager 334-502-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AL 20979) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-07-06 |