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Individual

CASSANDRA ALEXIS DEFORREST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
2015 HIGHPOINTE DR, BRANDON, MS 39042-3169
(601) 724-7310
Mailing address
861 WESTERLY DR, BRANDON, MS 39042-9579
(601) 383-4817

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT0843
MS

Other

Enumeration date
01/16/2018
Last updated
01/16/2018
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