| NPI | 1992991483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN STACY MOORE Owner/Physician 205-330-4989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 25444) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: AL 25444) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2010-03-22 |