| NPI | 1366890238 |
|---|---|
| Doing Business As | PEDIATRIC & ADOLESCENT CLINIC |
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN TIMM Owner 601-442-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2021-05-10 |