Organization
PREMIUM FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WILSON (OWNER)
(601) 529-0948
Entity
Organization
Contact information
Practice address
333 WHITESPORT DR SW STE 204, HUNTSVILLE, AL 35801-3455
(601) 566-3564
Mailing address
333 WHITESPORT DR SW STE 204, HUNTSVILLE, AL 35801-3455
(601) 566-3564
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2019
Last updated
06/09/2019
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