| NPI | 1790840080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE MONIQUE THOMAS Owner President 601-926-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MS 80151) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2008-03-12 |