Individual
ANNIE GRAY ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
762 FRENCH ROAD, VICTORIA, MS 38679
(632) 838-6856
Mailing address
PO BOX 121, VICTORIA, MS 38679-0121
(662) 838-6856
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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