Provider First Line Business Practice Location Address:
110 LENOIR HALL, SORORITY ROW
Provider Second Line Business Practice Location Address:
UM NUTRITION CLINIC, NHM DEPT., UNIV. OF MS
Provider Business Practice Location Address City Name:
UNIVERSITY
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38677-1848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-915-8662
Provider Business Practice Location Address Fax Number:
661-915-8663
Provider Enumeration Date:
07/11/2012