| NPI | 1396929907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN V. PRIESTER Member 601-353-2460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MS 851157) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |