| NPI | 1346424819 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | FRANK A. NICHOLS President 662-842-2170  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MS 07430)  | 
| Enumeration Date | 2007-12-19 | 
| Last Update Date | 2008-01-07 |