| NPI | 1841404985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL SAVELL Provider Enrollment 601-656-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2015-12-11 |