| NPI | 1942668397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY DEAN DILLARD Owner 334-875-7406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AL ACSC3813) |
| Enumeration Date | 2016-01-31 |
| Last Update Date | 2016-01-31 |