Individual
DORA L CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 FAIRWAY AVE, BYRAM, MS 39272-5527
(601) 815-5658
Mailing address
425 FAIRWAY AVE, BYRAM, MS 39272-5527
(601) 815-5658
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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