Organization
SUMMIT EXPRESS URGENT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. L NICOL PETTWAY M.D. (OWNER)
(205) 329-4565
Entity
Organization
Contact information
Practice address
1360 MONTGOMERY HWY, SUITE 124, VESTAVIA, AL 35216-2749
(205) 329-4565
Mailing address
4322 KINGS MOUNTAIN RDG, VESTAVIA, AL 35242-2242
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
19390
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376588095
NPI
AL
Enumeration date
12/23/2013
Last updated
12/23/2013
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