Individual
DAIWANA D CERTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
713 CHARLOTTE DR, PICAYUNE, MS 39466-4903
(601) 347-2928
Mailing address
PO BOX 1601, PICAYUNE, MS 39466-1601
(601) 347-2928
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
800340601
MS
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
04/20/2023
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