Clinton Wellness Center LLC

Organization Active NPI Family Medicine Physician · Clinton, MS

NPI 1124410410 · NPPES record last updated Feb 24, 2015

Key facts

NPI
1124410410
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CLINTON WELLNESS CENTER LLC
Practice address
322 Highway 80 E
Suite D
Clinton, MS 39056-4726
Phone
(318) 791-3765
Fax
(877) 747-5326
NPI assigned
Feb 24, 2015
Organization subpart
No

Authorized official

Name
Dr. Marco Moran, DPH
Title
Owner
Phone
(318) 791-3765

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

322 Highway 80 E
Suite D
Clinton, MS 39056-4726

Mailing address

PO Box 59294
Jackson, MS 39284-9294
Phone (318) 791-3765

Other providers in Clinton, MS

All providers in Clinton, MS · Family Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.