| NPI | 1295261642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR O ANAZIA Owner/Physician 601-827-5117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MS 1102452) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2019-01-17 |