Individual
MRS. ALANDA KNIGHT TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 MAIN ST., MEADVILLE, MS 39653-0240
(601) 384-2051
(601) 384-8334
Mailing address
PO BOX 240, MEADVILLE, MS 39653-0240
(601) 384-4532
(601) 384-8334
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
00-65210
MS
Other
Enumeration date
09/04/2015
Last updated
02/14/2023
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