Individual
KANAYO UGBOAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
157 HICKS ST, FAYETTE, MS 39069
(615) 717-5474
Mailing address
PO BOX 2244, FAYETTE, MS 39069
(615) 717-5474
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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