| NPI | 1376929901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH METALF President 228-594-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MS 097339) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MS 23941) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MS R791344) | |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-06 |