| NPI | 1720402266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK DEAN HOOVER Owner 228-497-2652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 15373) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-04 |