NPI | 1447744537 |
---|---|
Entity Type | Organization |
Authorized Contact | LAKEISHA MARIE CONLEY Physician/Owner 662-822-7454 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 32078) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2025-05-02 |