| NPI | 1508312992 |
|---|---|
| Other Name | MALLORY MOBILE RV CLINIC |
| Entity Type | Organization |
| Authorized Contact | CLYDE ROZELL CHAPMAN C Hief Exexcutive Officer 662-834-1857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2020-12-30 |