| NPI | 1154090157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILL MOON CEO 601-988-3831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |