| Life Transformation Medical Center Llc | |
|
806 Earl Frye Blvd Amory MS 38821-5505 | |
| (662) 597-9000 | |
| (662) 257-2083 |
| Full Name | Life Transformation Medical Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 806 Earl Frye Blvd, Amory, Mississippi |
| Authorized Official Name and Position | Crissy Harmon (OFFICE MANAGER) |
| Authorized Official Contact | 6625979000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Transformation Medical Center Llc 806 Earl Frye Blvd Amory MS 38821-5505 Ph: (662) 597-9000 | Life Transformation Medical Center Llc 806 Earl Frye Blvd Amory MS 38821-5505 Ph: (662) 597-9000 |
| NPI Number | 1558728469 |
|---|---|
| Provider Enumeration Date | 01/22/2016 |
| Last Update Date | 12/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558728469 | NPI | - | NPPES |
| 07227565 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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