Provider First Line Business Practice Location Address:
350 W WOODROW WILSON AVE
Provider Second Line Business Practice Location Address:
JACKSON-HINDS COMPREHENSIVE HEALTH CENTER
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39213-7681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-709-5130
Provider Business Practice Location Address Fax Number:
601-709-5141
Provider Enumeration Date:
01/11/2006