| NPI | 1871382051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY ANN BURTON Owner/Operator 662-515-0016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |