| NPI | 1407025711 |
|---|---|
| Doing Business As | PEDIATRIC & ADOLESCENT CLINIC |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE P RIFE Business Mgr 601-442-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2009-12-18 |