Organization
JULIA STREET CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNITA JAMES (ADMINISTRATOR)
(662) 962-7923
Entity
Organization
Contact information
Practice address
102 JULIA STREET, ISOLA, MS 38754
(662) 962-7923
Mailing address
PO BOX 553, ISOLA, MS 38754-0553
(662) 962-7923
(662) 962-2576
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01285834
—
MS
Enumeration date
03/07/2007
Last updated
08/22/2020
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