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1396289203
KENEEN CHILDRESS
TERRY, MS
NPI
1396289203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other Surgical Assistant
(Licence: MS 3224)
Enumeration Date
2016-12-12
Last Update Date
2016-12-12
Business Address
KENEEN CHILDRESS C.S.A
12035 SPRINGRIDGE RD
TERRY, MS 39170-8105
Phone number: 601-527-6290
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Mailing Address
KENEEN CHILDRESS C.S.A
12035 SPRINGRIDGE RD
TERRY, MS 39170-8105
Phone number:
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