| NPI | 1588846281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY JORDAN Owner 601-482-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: MS 14095) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2010-06-01 |