Individual
ANISSA QUANSHA ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2259 HICKORY DR, GREENVILLE, MS 38701-7912
(662) 931-6468
Mailing address
2259 HICKORY DR, GREENVILLE, MS 38701-7912
(662) 931-6468
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
MS
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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