| NPI | 1932523388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA PORTER-DI SALVO Partner/President 256-426-5389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD000040964) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN MD0000040964) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2015-09-28 |