| NPI | 1972843555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATAUR REHMAN Sole Member 256-240-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AL 28235) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2016-10-12 |