Individual
DARLEAN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
384 GRIFFIN RD, BENTONIA, MS 39040-9062
(601) 540-5522
(662) 673-0154
Mailing address
384 GRIFFIN RD, BENTONIA, MS 39040-9062
(601) 540-5522
(662) 673-0154
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-1873333
—
MS
Enumeration date
09/12/2018
Last updated
09/12/2018
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