| NPI | 1972017044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BOYLE Owner 256-828-4273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2017-12-12 |