| NPI | 1053684548 |
|---|---|
| Doing Business As | GRENADA SPECIALTY CLINIC - TERRY PUMMER |
| Entity Type | Organization |
| Authorized Contact | DAVID G. PUTT CEO 662-227-7000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 21836) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2014-03-18 |