| NPI | 1831672435 |
|---|---|
| Former Legal Business Name | HEALTHCAREONTHEGO |
| Entity Type | Organization |
| Authorized Contact | TEARRAH CONERLY Nurse Practitioner 601-938-0947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |