| NPI | 1417481474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS CROSS President 662-347-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 901361) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |