| NPI | 1295717056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA FULLENWIDER Owner 662-397-0913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MS 25D0859785) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2023-04-04 |