Provider First Line Business Practice Location Address:
303 MCKEE STREET
Provider Second Line Business Practice Location Address:
ARMSTRONG MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
STARKVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39759-3132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-324-4070
Provider Business Practice Location Address Fax Number:
662-324-4075
Provider Enumeration Date:
08/30/2011