| NPI | 1154733673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN YALTAH MULLEN Owner 228-396-5022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 14226) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2014-06-02 |