| NPI | 1144624073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK BOSTWICK Pathologist 601-927-7764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MS 04959) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-23 |