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Individual

MISS DIANE TOY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15387 U S HIGHWAY 49, BELZONI, MS 39038-4204
(662) 836-8740
Mailing address
PO BOX 114, ISOLA, MS 38754-0114
(662) 836-8740

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07003818
MS
Enumeration date
07/24/2007
Last updated
07/24/2007
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