| NPI | 1194379800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIECA DANIELLE SULLIVAN Phlebotomist 228-623-0708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |