Organization
ON THE MOVE MEDIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAKISHA R REDMOND RMA,CCMA, (OWNER)
(228) 265-2544
Entity
Organization
Contact information
Practice address
4405 29TH ST, GULFPORT, MS 39501-5814
(228) 265-2544
Mailing address
4405 29TH ST, GULFPORT, MS 39501-5814
(228) 265-2544
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/06/2013
Last updated
07/06/2013
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