| NPI | 1659556298 |
|---|---|
| Doing Business As | CHADWICK DRIVE CLINIC |
| Entity Type | Organization |
| Authorized Contact | YOLANDA W WILSON President 601-707-5381 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MS 12555) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2011-11-15 |