Individual
MAKENA BOEHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5219 HIGHWAY 51 N, SENATOBIA, MS 38668-1719
(662) 562-8266
Mailing address
190 LOVE RD, HERNANDO, MS 38632-0400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E010547
MS
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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