| NPI | 1699488072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MYLES Registered Nurse 662-836-8296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-02-22 |