| NPI | 1093058968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA MICHELLE BRANCH Certified Nurse Practioner 601-425-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MS R872330) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2013-03-29 |