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Organization

VICKSBURG CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE T BREWER (VP)
(877) 892-9813
Entity
Organization

Contact information

Practice address
1115 N FRONTAGE RD, VICKSBURG, MS 39180-5102
(601) 634-8790
Mailing address
1115 N FRONTAGE RD, VICKSBURG, MS 39180-5102
(601) 634-8790

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
05/24/2007
Last updated
04/12/2022
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