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1285142935
CASSANDRA ALEXIS DEFORREST
BRANDON, MS
NPI
1285142935
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine
(Licence: MS AT0843)
Enumeration Date
2018-01-16
Last Update Date
2018-01-16
Business Address
CASSANDRA ALEXIS DEFORREST ATC, LAT
2015 HIGHPOINTE DR
BRANDON, MS 39042-3169
Phone number: 601-724-7310
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Mailing Address
CASSANDRA ALEXIS DEFORREST ATC, LAT
861 WESTERLY DR
BRANDON, MS 39042-9579
Phone number: 601-383-4817
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