Organization
FAST PACE MISSISSIPPI, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYDNI CLEMMONS (CREDENTIALING MANAGER)
(901) 351-1791
Entity
Organization
Contact information
Practice address
619 S STATE ST, CLARKSDALE, MS 38614-6319
(662) 966-1012
Mailing address
PO BOX 306415, NASHVILLE, TN 37230-6415
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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