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Individual

MRS. EMMA TANKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
25 DAY ST, ROLLING FORK, MS 39159-5128
(662) 873-6964
Mailing address
PO BOX 490, ROLLING FORK, MS 39159-0490
(662) 873-6964

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Enumeration date
07/13/2010
Last updated
07/13/2010
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