Vicksburg Clinic LLC
NPI #1528298122 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1528298122
- Entity Type
- Organization
- Organization Name
- Vicksburg Clinic LLC
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Jul 17, 2009
- Last Updated
- Aug 12, 2009
Practice Location
- Address
- 1907 MISSION 66
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-3711
- Phone
- (601) 636-1173
Authorized Official
- Name
- DEBBIE T BREWER
- Title
- DIRECTOR
- Phone
- (877) 892-9813
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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