Individual
LATRICE R SPIVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9444 MCLEMORE CV, WALLS, MS 38680-9782
(901) 383-0773
Mailing address
9444 MCLEMORE CV, WALLS, MS 38680-9782
(901) 383-0773
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
88
TN
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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