| NPI | 1083764542 |
|---|---|
| Doing Business As | DELTA HEALTH PROVIDER BASED CLINICS |
| Entity Type | Organization |
| Authorized Contact | IRIS Y. STACKER CEO 662-725-2099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-10-17 |