| NPI | 1871392860 |
|---|---|
| Doing Business As | MAGNOLIA FAMILY WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | BYRON CLARK Office Manager/ Clinic Owner 601-410-6525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-06-11 |