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 |