| NPI | 1043680630 |
|---|---|
| Doing Business As | SOUTHERASTERN HEALTH MALL CLINIC |
| Entity Type | Organization |
| Authorized Contact | FORDHAM B BRITT Director 910-671-5026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2020-10-28 |