| NPI | 1003844978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA PERKINS Administrative Assistant 662-379-8141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2008-02-11 |