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 |