| NPI | 1417545922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB CORNELIUS PARKER Specialist Technologist 601-264-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2021-01-10 |
| Last Update Date | 2021-01-13 |