| NPI | 1558672022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA THORNTON Nurse Practitioner 662-562-8278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: MS R873355) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |