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
5713 HIGHWAY 45 ALT S, WEST POINT, MS 39773-0414
(931) 253-1101
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
12/09/2021
Last updated
12/09/2021
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