Individual
TANAKA KNIGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1198 MISTY LN, TERRY, MS 39170-9311
(601) 613-8944
Mailing address
1198 MISTY LN, TERRY, MS 39170-9311
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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