Individual
MRS. MINNIE C DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2871 WOODSIDE DR, JACKSON, MS 39212-2617
(601) 882-3300
Mailing address
PO BOX 6642, JACKSON, MS 39282-6642
(601) 882-3300
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
MS
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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