| NPI | 1154506277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L DENTON CEO 662-227-7005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: MS 11-245) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |