NPI | 1831132562 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN C. BERRY Owner 662-624-2466 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R659975) |
Enumeration Date | 2006-06-13 |
Last Update Date | 2020-08-22 |