| NPI | 1356484604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ROY TODD Owner 601-446-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: MS 06605) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2013-06-20 |