| NPI | 1952843450 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | BROOKELYN VANHOOZER Executive Assistant 256-325-1540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AL 1-146611) |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2018-05-04 |