Individual
MARKITA SHERISE GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
60 PROCTOR ST, WALNUT, MS 38683
(731) 212-0457
Mailing address
60 PROCTOR ST, WALNUT, MS 38683-9623
(731) 212-0457
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
TN
Other
Enumeration date
08/08/2016
Last updated
02/08/2019
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