| NPI | 1467137372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA NICHOLE BLACKMORE Director Of Clinic Operations/ Om 228-209-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |