Pine Grove Association
NPI #1871316257 in Canton, Mississippi
Provider Information
- NPI Number
- 1871316257
- Entity Type
- Organization
- Organization Name
- Pine Grove Association
- Primary Specialty
- General Practice
- Enumeration Date
- Nov 5, 2024
- Last Updated
- Dec 5, 2024
Practice Location
- Address
- 1134 BARNES RD
- City
- Canton
- State
- Mississippi
- ZIP Code
- 39046
- Phone
- (601) 761-9424
Authorized Official
- Name
- ANGELA CARSON
- Title
- EXECUTIVE DIRECTOR
- Phone
- (601) 955-1132
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Practice |
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