Individual
DESTINY PRISOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 OLIVE DR, GALLION, AL 36742-2415
(334) 216-5470
Mailing address
PO BOX 208, GALLION, AL 36742-0208
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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