Individual
LAWRENCE SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19150 HIGHWAY 61 N, LYON, MS 38645-9779
(662) 902-4614
Mailing address
19150 HIGHWAY 61 N, LYON, MS 38645-9779
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
800040716
MS
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
About Stedi
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