Individual
DOMINIC LASHAY FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2744 HWY 51 SOUTH, HERNANDO, MS 38632
(662) 449-1971
Mailing address
2104 MABYLINE ST, GREENWOOD, MS 38930-6024
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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