Individual
QUINTRICA UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2725 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(901) 229-2942
Mailing address
2725 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(901) 229-2942
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262449011
—
MS
Enumeration date
01/17/2018
Last updated
01/24/2018
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