Individual
DAVID D DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
141 FRIENDSHIP CHURCH RD, COLUMBIA, MS 39429-3942
(601) 736-5460
(601) 736-5831
Mailing address
141 FRIENDSHIP CHURCH RD, COLUMBIA, MS 39429-6457
(601) 736-5460
(601) 736-5831
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
802034765
MS
Other
Enumeration date
04/03/2018
Last updated
04/03/2018
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