Organization
WHOLESOME TRIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY THOMPSON RN (OWNER)
(601) 287-2143
Entity
Organization
Contact information
Practice address
115 DOGWOOD DR, HAZLEHURST, MS 39083-2903
(601) 287-2143
Mailing address
115 DOGWOOD DR, HAZLEHURST, MS 39083-2903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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