| NPI | 1205218690 |
|---|---|
| Doing Business As | THERESA RENEE KING |
| Entity Type | Organization |
| Authorized Contact | THERESA RENEE KING Owner/Pres. Nurse. Practitioner 601-826-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |