| NPI | 1386673036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES KENNETH LIPPINCOTT Owner 662-844-3739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 09148) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2013-01-03 |