Individual
MICAH DEON DIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1195 ROBERTS RD N, MERIDIAN, MS 39301-8625
(601) 527-3929
Mailing address
1195 ROBERTS RD N, MERIDIAN, MS 39301-8625
(601) 527-3929
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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