Individual
BEVERLY FORREST-BUTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
407 NW DEPOT ST, DURANT, MS 39063-3705
(662) 230-0947
Mailing address
510 CHURCH ST, WINONA, MS 38967-2802
(662) 230-0947
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
802066241
MS
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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