| NPI | 1063659340 |
|---|---|
| Doing Business As | 809 CONVENIENT CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRISTAL ROGERS Office Assistant 601-982-0673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R656046) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MS P320574) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |