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Individual

KNIESHA KATHERINE SCRUGGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1461 STEELE ST, JACKSONVILLE, FL 32209-6263
(904) 415-9228
Mailing address
6982 CLEARWATER PARK CT S, JACKSONVILLE, FL 32244-7809
(904) 415-9228

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
37
FL

Other

Enumeration date
10/18/2011
Last updated
10/18/2011
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