Individual
DERIONNE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
972 HATHORN ROAD, UNIVERSITY, MS 38655
(504) 496-1361
Mailing address
407 BEAUREGARD CIR, OXFORD, MS 38655-5063
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0742
MS
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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