Living Waters Community Medical Center Pllc
NPI #1144403122 in Pass Christian, Mississippi
Provider Information
- NPI Number
- 1144403122
- Entity Type
- Organization
- Organization Name
- Living Waters Community Medical Center Pllc
- Primary Specialty
- Specialist
- Enumeration Date
- Dec 12, 2007
- Last Updated
- Dec 12, 2007
Practice Location
- Address
- 13472 VIDALIA RD
- City
- Pass Christian
- State
- Mississippi
- ZIP Code
- 39571-8300
- Phone
- (228) 586-2455
Authorized Official
- Name
- MRS. LISA MARIE TILLMAN
- Title
- OFFICE MANAGER
- Phone
- (228) 586-2455
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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