Provider First Line Business Practice Location Address:
SOUTH 28TH AVENUE FAMILY MEDICINE
Provider Second Line Business Practice Location Address:
1101 SOUTH 28TH AVENUE, SUITE C
Provider Business Practice Location Address City Name:
HATTIESBURG
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-261-1670
Provider Business Practice Location Address Fax Number:
601-579-5240
Provider Enumeration Date:
08/16/2018