Vicksburg Clinic LLC
NPI #1154532257 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1154532257
- Entity Type
- Organization
- Organization Name
- Vicksburg Clinic LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- May 24, 2007
- Last Updated
- Apr 12, 2022
Practice Location
- Address
- 1115 N FRONTAGE RD
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-5102
- Phone
- (601) 634-8790
Authorized Official
- Name
- DEBBIE T BREWER
- Title
- VP
- Phone
- (877) 892-9813
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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