| NPI | 1952694994 |
|---|---|
| Doing Business As | MAIN STREET MEDICAL CLINIC OF MORTON |
| Entity Type | Organization |
| Authorized Contact | JOHN P LEE Chairman Of The Board 601-469-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2020-05-26 |