| NPI | 1134741945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY MOWDY President 601-730-0602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2025-03-03 |