Individual
MS. JOAN LASHALL JUNEARICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
813 VARSITY DR, TUPELO, MS 38801-4703
(662) 844-9763
(662) 844-9763
Mailing address
PO BOX 912, VERONA, MS 38879-0912
(662) 844-9763
(662) 844-9763
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03537734
—
MS
Enumeration date
05/09/2006
Last updated
11/15/2010
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