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Individual

TIFFANY STURDIVANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1504 23RD ST N, COLUMBUS, MS 39701-2528
(662) 609-4976
(662) 223-3051
Mailing address
1504 23RD ST N, COLUMBUS, MS 39701-2528
(662) 609-4976
(662) 223-3051

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
1059530
MS

Other

Enumeration date
01/12/2017
Last updated
01/12/2017
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