| NPI | 1417230186 |
|---|---|
| Doing Business As | B/BA PERFORMANCE WEIGHT LOSS AND MEDISPA |
| Entity Type | Organization |
| Authorized Contact | CARYN ALISON JOHNSON Owner 601-624-5840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MS R869964) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2012-02-13 |