| NPI | 1295488393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD HEWITT CEO 601-966-5601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-01-28 |