Individual
CORIANTON ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
660 POWER CIR, BILOXI, MS 39531-2565
(208) 709-6459
Mailing address
660 POWER CIR, BILOXI, MS 39531-2565
(208) 709-6459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
38396
ID
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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