| NPI | 1962455881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY S. TATE Chief Executive Officer 251-470-5842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2008-04-20 |