| NPI | 1720253735 |
|---|---|
| Doing Business As | CHURCH STREET CLINIC |
| Entity Type | Organization |
| Authorized Contact | RAY SHOEMAKER CEO 662-321-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-06-09 |