| NPI | 1275824773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT NEAL SUARES Owner 662-332-8131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 20731) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2011-10-20 |