| Organization Name: | CRENSHAW IMMEDIATE CARE LLC |
| NPI Number: | 1134439326 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICTORIA FRANCIS LAWRENSON (MANAGING PARTNER) |
| Mailing Address: | 5303 Vaughn Road Montgomery |
| State: | AL US |
| Postal Code: | 361161120 |
| Phone Number: | 3343860343 |
| Fax Number: | 3343860382 |
| NPI Enumeration Date: | 10/21/2010 |
| NPI Last Update Date: | 10/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |