Individual
ANTAVIOUS KEMAR BELGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2623 5TH ST N, COLUMBUS, MS 39705-2009
(662) 245-0511
Mailing address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
(769) 251-5550
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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