Individual
MISS BEVERLY G DEDUAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18114 S VILLAGE DR, SAUCIER, MS 39574-6520
(228) 263-4352
Mailing address
18114 S VILLAGE DR, SAUCIER, MS 39574-6520
(228) 263-4352
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1124
MS
Other
Enumeration date
10/12/2022
Last updated
01/11/2024
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