Individual
MR. MORRISON DWIGHT MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
309 LACOSTE CT, BRANDON, MS 39047-7104
(601) 622-5499
(601) 352-8452
Mailing address
309 LACOSTE CT, BRANDON, MS 39047-7104
(601) 622-5499
(601) 352-8452
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1178960
MS
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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