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Individual

MRS. SHALONDA MACHELLE HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5463 LUCIUS TAYLOR RD, COMO, MS 38619-9312
(662) 519-6160
Mailing address
5463 LUCIUS TAYLOR RD, COMO, MS 38619-9312
(662) 519-6160

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
800502448
MS

Other

Enumeration date
05/04/2018
Last updated
05/04/2018
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