| NPI | 1013961580 |
|---|---|
| Former Legal Business Name | TRI LAKES WOMEN CLINIC |
| Entity Type | Organization |
| Authorized Contact | RAY L SHOEMAKER CEO 662-712-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-08-22 |