Individual
MYRA JANE SIKORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
8601 CROWS NEST RD, VANCLEAVE, MS 39565-9098
(228) 826-5011
Mailing address
8601 CROWS NEST RD, VANCLEAVE, MS 39565-9098
(228) 826-5011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1261
MS
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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