| NPI | 1538524582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUITA DR THURMAN Sole Propreitor/ Owner 662-420-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 1079661) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |