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1376216861
ANDREA ELLIS
JACKSON, MS
NPI
1376216861
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747A0650X Technician, Attendant Care Provider
Enumeration Date
2021-07-29
Last Update Date
2021-07-29
Business Address
ANDREA ELLIS
4144 DEL ROSA DR
JACKSON, MS 39206-4732
Phone number: 601-572-5631
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Mailing Address
ANDREA ELLIS
4144 DEL ROSA DR
JACKSON, MS 39206-4732
Phone number: 601-572-5631
Copy
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