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Individual

KEISHIA JUSTICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMF

Contact information

Practice address
661 TIFFANY BLVD, ROCKY MOUNT, NC 27804-1802
(252) 904-2581
(252) 557-3557
Mailing address
661 TIFFANY BLVD, ROCKY MOUNT, NC 27804-1802

Taxonomy

Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
C54057
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00441264
NC
Enumeration date
10/20/2016
Last updated
09/30/2025
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