NPI | 1306726641 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL FREDERICK COOPER Scientific Director 332-495-8104 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2025-09-05 |
Last Update Date | 2025-09-08 |