| NPI | 1205425535 |
|---|---|
| Other Name | MALLORY MOBILE RV CLINIC 2 |
| Entity Type | Organization |
| Authorized Contact | LATONYA MABRY Business Manager 662-834-0746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |