| NPI | 1174294797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE WHITEHEAD Managing Nurse Practitioner 662-427-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2022-04-21 |