| NPI | 1528273315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE E CUMMINGS Owner 662-627-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MS 12250) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-03-17 |