Madison Healthplex and Sports Performance Center LLC
NPI #1184174914 in Madison, Mississippi
Provider Information
- NPI Number
- 1184174914
- Entity Type
- Organization
- Organization Name
- Madison Healthplex and Sports Performance Center LLC
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Oct 5, 2016
- Last Updated
- Oct 5, 2016
Practice Location
- Address
- 501 BAPTIST DR
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110-2030
- Phone
- (601) 856-7757
Authorized Official
- Name
- GREG CENTILLI
- Title
- EXECUTIVE DIRECTOR
- Phone
- (601) 856-7757
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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