| NPI | 1073996005 |
|---|---|
| Doing Business As | DIABETES TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | GERALD KIMBROUGH Manager 662-377-4685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2017-04-07 |