| NPI | 1437373164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS RENEE WRIGHT Owner 662-252-9987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-03-14 |