Individual
CYNTHIA LEE DEDEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
21271 LAWRENCE LADNER RD, KILN, MS 39556-6490
(228) 493-8514
(228) 255-2515
Mailing address
21271 LAWRENCE LADNER RD, KILN, MS 39556-6490
(228) 493-8514
(228) 255-2515
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0044
MS
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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