Organization
DELTA WELLNESS CLINIC FOR FAMILIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE COLBERT CPC (BUSINESS MANAGER)
(662) 332-8848
Entity
Organization
Contact information
Practice address
1585 S MAIN ST, GREENVILLE, MS 38701-7008
(662) 332-8848
(662) 332-8854
Mailing address
PO BOX 4577, GREENVILLE, MS 38704-4577
(662) 332-8848
(662) 332-8854
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
14161
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114839
—
MS
Enumeration date
06/20/2013
Last updated
06/20/2013
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