Individual
LATANIZA BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
67 AUSTIN GUY RD, TYLERTOWN, MS 39667-7036
(601) 520-8858
Mailing address
67 AUSTIN GUY RD, TYLERTOWN, MS 39667-7036
(601) 520-8858
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1068980
MS
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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