Fast Pace Mississippi, Pllc
NPI #1740947019 in Ellisville, Mississippi
Provider Information
- NPI Number
- 1740947019
- Entity Type
- Organization
- Organization Name
- Fast Pace Mississippi, Pllc
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Nov 22, 2021
- Last Updated
- Nov 22, 2021
Practice Location
- Address
- 305 HILL ST
- City
- Ellisville
- State
- Mississippi
- ZIP Code
- 39437-2521
- Phone
- (601) 800-0118
Authorized Official
- Name
- SYDNI CLEMMONS
- Title
- CREDENTIALING MANAGER
- Phone
- (901) 351-1791
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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