| NPI | 1205083110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BURKE MARTIN Doctor/Owner 228-875-3097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MS ms5001) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |