| NPI | 1508202268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY OWENS Physician 228-331-3310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 20354) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |