| NPI | 1497141337 |
|---|---|
| Doing Business As | OMNIS HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | AMANDA FONDREN Owner/Nurse Practitioner 662-251-7389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R858548) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-09-16 |