Individual
MR. DANNY WILLIAMS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8177 HIGHWAY 178, OLIVE BRANCH, MS 38654-1172
(662) 822-9651
Mailing address
7412 IVY TRAILS CV, OLIVE BRANCH, MS 38654-7171
(901) 630-7877
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
790CB6C585
—
MS
Enumeration date
02/21/2023
Last updated
02/21/2023
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