AUSTIN HARBOR BLACK

MANTACHIE, MS
NPI1245017052
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  906272)
Enumeration Date2023-09-13
Last Update Date2023-09-13
Business Address
AUSTIN HARBOR BLACK FNP-BC
5681 HIGHWAY 363
MANTACHIE, MS 38855-7632
Phone number: 662-282-4226
Mailing Address
AUSTIN HARBOR BLACK FNP-BC
PO BOX 40
MANTACHIE, MS 38855-0040
Phone number: 662-282-4226
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