| NPI | 1194177170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK O RESTER Owner 601-326-7632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MS 16623) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2016-08-03 |