| NPI | 1538494653 |
|---|---|
| Doing Business As | EAST JACKSON FAMILY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JAMA M PHILLIPS Director 731-512-1510 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2011-09-13 |