Individual
TA'QUORIS ASHUAD NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
802 LAKELAND DR APT 258, JACKSON, MS 39216-4623
(228) 547-6139
Mailing address
802 LAKELAND DR APT 258, JACKSON, MS 39216-4623
(228) 547-6139
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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