Individual
RODERICK JOSEPH SHANKS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1636 N POPPS FERRY RD # A2 & A4, BILOXI, MS 39532-2217
(228) 967-7991
(228) 967-7999
Mailing address
1636 N POPPS FERRY RD # A2 & A4, BILOXI, MS 39532-2217
(228) 967-7991
(228) 967-7999
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
4505
MS
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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