| NPI | 1548809403 |
|---|---|
| Doing Business As | MIZELL MEDICAL CLINIC 2 |
| Entity Type | Organization |
| Authorized Contact | JANA WYATT CEO / CFO 334-493-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2019-12-24 |
| Last Update Date | 2021-01-14 |