Individual
TIFFANY-RAE LANI OGLESBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
795 COUNTY ROAD 148, NEW BROCKTON, AL 36351-8106
(334) 406-0066
Mailing address
795 COUNTY ROAD 148, NEW BROCKTON, AL 36351-8106
(334) 406-0066
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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