| NPI | 1821375767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ANTHONY HANCOCK President 601-656-8710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MS 0953) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2011-11-07 |