| NPI | 1841357704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALVIN BRUCE Owner 601-939-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MS 25C0001016) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2016-12-15 |