| NPI | 1508936485 |
|---|---|
| Doing Business As | TRI-LAKES PEDIATRIC RHC CLINIC |
| Entity Type | Organization |
| Authorized Contact | JENNY HERRON Hmpn 662-563-5611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2013-04-23 |