Organization
PROHEALTH SELMA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY WHITE PHD (EXECUTIVE DIRECTOR)
(334) 418-5081
Entity
Organization
Contact information
Practice address
1107 VOEGLIN AVE, SELMA, AL 36703-4301
(334) 418-5081
(334) 418-5083
Mailing address
PO BOX 681151, FRANKLIN, TN 37068-1151
(615) 591-4750
(615) 591-4737
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/09/2005
Last updated
09/05/2007
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