Individual
TIERRA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 HARBOUR POINTE XING STE 303, RIDGELAND, MS 39157-1152
(601) 301-9912
Mailing address
583 OLD JACKSON RD APT 1315, CANTON, MS 39046-0515
(769) 237-0443
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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