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Organization

MADISON HEALTHPLEX AND SPORTS PERFORMANCE CENTER LLC

Active
Other names
Madison Healthplex Performance Training Center
Organization subpart
No

Provider details

NPI number
Authorized official
GREG CENTILLI (EXECUTIVE DIRECTOR)
(601) 856-7757
Entity
Organization

Contact information

Practice address
501 BAPTIST DR, MADISON, MS 39110-2030
(601) 856-7757
(601) 944-9780
Mailing address
501 BAPTIST DR, MADISON, MS 39110-2030
(601) 856-7757
(601) 944-9780

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
10/05/2016
Last updated
10/05/2016
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