| NPI | 1093045908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG G PARKER Fnp 228-385-3774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: MS R791344) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: MS R868142) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2009-12-28 |