| NPI | 1962826743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICIA R ALLEN President 228-234-7324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2015-02-11 |