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Individual

MS. KANESHA PONJETTA THAGARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
171 MASON ST, HAYNEVILLE, AL 36040-6408
(334) 301-0009
Mailing address
171 MASON ST, HAYNEVILLE, AL 36040-6408
(334) 301-0009

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
AL

Other

Enumeration date
11/17/2022
Last updated
11/17/2022
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