NPI | 1831240928 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMI C. ADAMS Credentialing Specialist 228-818-5521 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MS 016) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2016-11-16 |