| NPI | 1932476280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DEVELIN Owner 601-824-9490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MS R633283) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |