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Individual

KULMORIS JOINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
350 WEST WOODROW WILSON AVENUE, SUITE 145, JACKSON, MS 39213
(601) 807-5496
(769) 233-8840
Mailing address
350 W WOODROW WILSON AVE, SUITE 145, JACKSON, MS 39213-7681
(601) 807-5496
(769) 233-8840

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
06023302
MS
376J00000X
Homemaker
05671361
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05671361
MS
05
06023302
MS
Enumeration date
03/27/2015
Last updated
03/30/2015
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