Individual
MR. DEWAYNE TROY PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 SMITH AVE, CLEVELAND, MS 38732-4059
(662) 588-5283
Mailing address
1101 SMITH AVE, CLEVELAND, MS 38732-4059
(662) 588-5283
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
B1208544
MS
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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