Individual
TAMMIE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 LANOAH LN, BRANDON, MS 39042-7897
(601) 209-9490
Mailing address
212 LANOAH LN, BRANDON, MS 39042-7897
(601) 209-9490
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12529
MS
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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