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Organization
SHALOM FAMILY PRACTICE AND MEDICAL SPA LLC.
Active
Organization
SHALOM FAMILY PRACTICE AND MEDICAL SPA LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IBUKUNOLUWA PICKENS D.O. (OWNER/D.O.)
(256) 469-0350
Entity
Organization
Contact information
Practice address
333 WHITESPORT DR SW STE 304, HUNTSVILLE, AL 35801-3455
(256) 469-0350
(256) 291-3611
Mailing address
333 WHITESPORT DR SW STE 304, HUNTSVILLE, AL 35801-3455
(256) 469-0350
(256) 291-3611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
04/11/2023
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