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Individual

MR. DEVAN LAMONTE STRANGE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
177 MIGGINS RD, CANTON, MS 39046-9162
(601) 761-4315
Mailing address
4780 I 55 N STE 100, JACKSON, MS 39211-5583
(601) 761-2025

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
801131590
MS
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
01/10/2019
Last updated
06/11/2021
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