| NPI | 1134166812 |
|---|---|
| Doing Business As | CENTREVILLE CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEREMY CHAD NETTERVILLE Administrator 601-890-0545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208600000X Surgery | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2019-09-12 |