Organization
HANDS OF GODDESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEKORY JUANTE JEFFERSON (PRESIDENT/CEO)
(601) 316-0156
Entity
Organization
Contact information
Practice address
208 E GEORGETOWN ST, CRYSTAL SPRINGS, MS 39059-2517
(601) 308-5150
(601) 308-5157
Mailing address
208 E GEORGETOWN ST, CRYSTAL SPRINGS, MS 39059-2517
(601) 308-5150
(601) 308-5157
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
R603643
MS
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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