| NPI | 1174078711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA WILLINGHAM Medical Director 662-466-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MS 19693) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |