| NPI | 1003005125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW CURRY JUSTICE Owner 662-963-9146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS R850606) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MS R682403) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2012-11-13 |