| NPI | 1124031521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BESSIE L. MAGEE Owner 601-876-6784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MS P228311) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-22 |