| NPI | 1467993352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE RUTH REINHARD CEO 601-990-2963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 17415) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |