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General NPI Number Information
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NPI Number | 1376034827
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Entity Type | Organization
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Legal Business Name | GUYS INTEGRATIVE MEDICINE INSTITUTE
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 1220 LASALLE ST STE A
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City | MCCOMB
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State | MS
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Zip | 39648-5158
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Country | US
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Telephone | 601-684-4127
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 FRANKLIN ST SE STE 110
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4537
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Country | US
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Telephone | 256-533-1268
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | TONJA WILLIAMS
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Credential |
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Telephone | 256-533-1268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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