| NPI | 1275130601 |
|---|---|
| Doing Business As | LACKEY PAIN CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOHN P LEE Medical Director 601-469-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |