| NPI | 1235586363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERLENCIA R MYERS Co Owner 601-622-4677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MS R876299) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |