| NPI | 1093214819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEKAH ELIZABETH HENDERSON Or Aministrator 601-391-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2024-03-12 |