Individual
MRS. AUGUSTA FOREST SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 PINE STREET, MOORHEAD, MS 38761
(662) 303-0058
Mailing address
1401 PINE STREET / P.O. BOX 82, MOORHEAD, MS 38761
(662) 303-0058
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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