121 Medical Place, INC
NPI #1588106553 in Mendenhall, Mississippi
Provider Information
- NPI Number
- 1588106553
- Entity Type
- Organization
- Organization Name
- 121 Medical Place, INC
- Primary Specialty
- Clinic/Center - Community Health
- Enumeration Date
- Nov 8, 2016
- Last Updated
- Aug 6, 2025
Practice Location
- Address
- 820 MANGUM AVE
- City
- Mendenhall
- State
- Mississippi
- ZIP Code
- 39114-3025
- Phone
- (601) 906-1897
Authorized Official
- Name
- SHELLEY LEACH, FNP-C
- Title
- PRESIDENT
- Phone
- (601) 906-1897
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Community Health — Community Health |
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