Organization
FAITH FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY BERNICE THORNTON APRN, BC (FAMILY NURSE PRACTITIONER/CO-OWNER)
(662) 415-0270
Entity
Organization
Contact information
Practice address
2209 N 2ND ST, BOONEVILLE, MS 38829-7734
(662) 728-0162
Mailing address
2209 N 2ND ST, BOONEVILLE, MS 38829-7734
(662) 728-0162
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2006
Last updated
10/14/2011
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