| NPI | 1033454459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YULONDA LUTER CEO 601-731-4639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MS 7748) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2015-08-11 |