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Active
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY OLLLIE MORGAN (PRESIDENT)
(334) 780-1104
Entity
Organization

Contact information

Practice address
2944 ROSS CLARK CIR, DOTHAN, AL 36301-1161
(334) 699-3009
Mailing address
2944 ROSS CLARK CIR, DOTHAN, AL 36301-1161
(334) 699-3009

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
05/23/2023
Last updated
05/23/2023
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