| NPI | 1437883584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY NICHELLE MCMULLION Owner/Administer 229-415-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-14 |