| NPI | 1982216669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOTAYO ANDREA PRYOR C RN P 256-348-2107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-08-23 |
| Last Update Date | 2023-12-30 |