Grenada Adult Healthcare Clinic Pc.
NPI #1144478512 in Grenada, Mississippi
Provider Information
- NPI Number
- 1144478512
- Entity Type
- Organization
- Organization Name
- Grenada Adult Healthcare Clinic Pc.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Aug 28, 2008
- Last Updated
- Aug 29, 2008
Practice Location
- Address
- 965 J K AVENT DR
- Address 2
- SUITE 106
- City
- Grenada
- State
- Mississippi
- ZIP Code
- 38901-5045
- Phone
- (662) 227-6450
Authorized Official
- Name
- DR. JUSTICE AARON GONDWE, M.D.
- Title
- PRESIDENT
- Phone
- (662) 227-6450
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
| Clinic/Center - Primary Care — Primary Care |
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