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Organization
BAPTIST NUTRITION CLINIC
Active
Organization
BAPTIST NUTRITION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRISSETT (DIRECTOR)
(601) 944-1717
Entity
Organization
Contact information
Practice address
1190 N STATE ST, SUITE 204, JACKSON, MS 39202-2413
(601) 944-1717
(601) 944-9780
Mailing address
1190 N STATE ST, SUITE 204, JACKSON, MS 39202-2413
(601) 944-1717
(601) 944-9780
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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