Provider First Line Business Practice Location Address:
732 WHITFIELD STREET
Provider Second Line Business Practice Location Address:
MISSISSIPPI STATE BOARD OF HEALTH DISTRICT IV
Provider Business Practice Location Address City Name:
STARKVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-323-7313
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2006