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Individual

LA CHENDARA GRASPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1410 HIGHWAY 90, GAUTIER, MS 39553-5449
(228) 355-7061
Mailing address
1617 WHITEWOOD DR, GAUTIER, MS 39553-2627
(228) 355-7061

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
MS

Other

Enumeration date
09/08/2025
Last updated
09/08/2025
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