Organization
CALEB MOUNTAIN CLIMBING WHOLISTIC INTERNATIONAL CENTER LLC
Active
Other names
Solid-Rock Comprehensive Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIDGET Y TAH-CLAYTON DO (OWNER)
(601) 606-5771
Entity
Organization
Contact information
Practice address
610 ADELINE ST STE 1A, HATTIESBURG, MS 39401-3875
(601) 606-5771
(800) 489-0211
Mailing address
610 ADELINE ST STE 1A, HATTIESBURG, MS 39401-3875
(601) 606-5771
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122708
—
MS
Enumeration date
08/24/2019
Last updated
08/24/2019
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