Individual
DOMINIQUE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E CENTER ST, CANTON, MS 39046-3733
(769) 220-2848
Mailing address
644 WAY RD, CANTON, MS 39046-8708
(769) 220-2848
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
—
MS
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/01/2024
Last updated
01/01/2024
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