| NPI | 1104166362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL M MCLEOD Owner 601-709-0607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MS 12138) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2013-02-26 |