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Organization

ROLLING FORK EYE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. RUTH C ANDERSON (PRACTICE MANAGER)
(662) 332-0163
Entity
Organization

Contact information

Practice address
64 S FOURTH ST, ROLLING FORK, MS 39159-5147
(662) 873-4045
(662) 873-4452
Mailing address
PO BOX 185, ROLLING FORK, MS 39159-0185
(662) 873-4045
(662) 873-4452

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00087850
MS
Enumeration date
04/10/2007
Last updated
08/22/2020
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