| NPI | 1649851171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE GALE HALLMARK Director Of Reimbursement 662-377-5186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |