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General NPI Number Information
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NPI Number | 1932989191
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Entity Type | Organization
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Legal Business Name | HERB MEDICAL CONSULTING
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 2785 HIGHWAY 145
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City | SALTILLO
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State | MS
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Zip | 38866-9783
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Country | US
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Telephone | 662-372-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 116 WATERFORD DR
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City | SALTILLO
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State | MS
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Zip | 38866-5706
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Country | US
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Telephone | 166-232-2627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA KING
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Credential | FNP-BC
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Telephone | 662-372-5308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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