NPI | 1962293084 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTIN PARDEN Owner/AO 334-659-4717 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0129X |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2025-05-16 |
Last Update Date | 2025-05-16 |