| NPI | 1164129755 |
|---|---|
| Doing Business As | 4D HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | TANYA S COCKRELL Owner/Operator 662-630-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2023-02-14 |