Organization Name: | HEALTH CARE CLINIC OF MISSISSIPPI, LLC |
NPI Number: | 1679639579 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CLARA T. REED (CEO) |
Mailing Address: | 4213 Highway 49 Drew |
State: | MS US |
Postal Code: | 387379525 |
Phone Number: | 6627450305 |
Fax Number: | 6627450204 |
NPI Enumeration Date: | 12/28/2006 |
NPI Last Update Date: | 07/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |