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Individual

KEIVIA LATRICE HARDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3362 ATLANTA HWY, MONTGOMERY, AL 36109-2702
(334) 324-9224
Mailing address
7036 BUCKRAM OAK DR, MONTGOMERY, AL 36117-6724
(334) 324-9224

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
121503
AL

Other

Enumeration date
10/24/2017
Last updated
10/24/2017
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