NPI | 1558693192 |
---|---|
Entity Type | Organization |
Authorized Contact | JUDY L JARRELL Business Office Manager 228-392-8881 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MS 19018) |
Enumeration Date | 2010-02-08 |
Last Update Date | 2010-02-08 |