| NPI | 1003148859 |
|---|---|
| Doing Business As | FMCH GLOSTER CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEREMY CHAD NETTERVILLE CEO 601-645-5221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |