| NPI | 1326797978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BURTON Co Owner 601-480-5947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-03-21 |