| NPI | 1639797442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELECIA SMITH Managing 601-899-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |