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Organization
CLINTON WELLNESS CENTER LLC
Active
Organization
CLINTON WELLNESS CENTER LLC
Active
Other names
ICare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHINITA REED DUDLEY M.D (PHYSICIAN)
(601) 714-8180
Entity
Organization
Contact information
Practice address
514 E WOODROW WILSON AVE, SUITE C, JACKSON, MS 39216-4538
(601) 714-8180
(601) 922-9900
Mailing address
514 E WOODROW WILSON AVE, SUITE C, JACKSON, MS 39216-4538
(601) 714-8180
(601) 922-9900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18239
MS
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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