Individual
CARLIE STANFORD DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
660 E MADISON ST, HOUSTON, MS 38851-2411
(662) 456-9244
Mailing address
660 E MADISON ST, HOUSTON, MS 38851-2411
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-101202
MS
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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