institution
Phyllis G Koonce
Rural Health Clinic/Center in Blue Mountain, Mississippi
NPI 1891911186

Phyllis G Koonce is a Rural Health Clinic/Center based in Blue Mountain, MS and is specialized in Rural Health. Phyllis G Koonce practices in Blue Mountain, MS. The NPI Number for Phyllis G Koonce is 1891911186 and holds a License No. R125960 (Mississippi).

The current practice location address for Phyllis G Koonce is 100 County Road 714, Blue Mountain, MS and can be reached out via phone at 662-538-4111 and via fax at 662-538-4128.

Location: 100 County Road 714, Blue Mountain, MS, 38610-9743
institution
Provider Profile Details
NPI Number
1891911186
Provider Name
Phyllis G Koonce
Credential
Provider Entity Type
Organization
Address
100 County Road 714, Blue Mountain, MS, 38610-9743
Phone Number
662-538-4111
Fax Number
662-538-4128
Provider Enumeration Date
04/17/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
06577891 05 MS
institution
Provider Business Practice Location Address Details
Address
100 County Road 714
City
State
Zip
38610-9743
Phone Number
662-538-4111
Fax Number
662-538-4128
person
Provider Business Mailing Address Details
Address
100 County Road 714
City
State
Zip
38610-9743
Phone Number
662-538-4111
Fax Number
662-538-4128
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
License No.
R125960 (Mississippi)
Definition
Definition to come...
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