| NPI | 1174979199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CONWAY CFO 601-543-2849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: MS 21276) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-05-17 |