| NPI | 1952719551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYNDOL SPAN HAMER Physician 256-294-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AL 9756) |
| Enumeration Date | 2014-07-27 |
| Last Update Date | 2014-08-22 |