| NPI | 1407743974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY MARK Owner 601-522-0963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-06-18 |