| NPI | 1558570978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG SHOEMAKER Assoc. Admin. Of Bus. Development 228-497-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2009-03-30 |