Individual
RICKANESHA MCKINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SP
Contact information
Practice address
1020 S BREAZEALE AVE, MOUNT OLIVE, NC 28365-8572
(919) 920-3923
Mailing address
103 MENCY PL, MOUNT OLIVE, NC 28365-2801
(919) 920-3923
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
C58596
NC
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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