WANDERFUL PORTER

TUPELO, MS
NPI1407833221
Former NameWANDA E FORD
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MS  R748355)
Enumeration Date2005-12-22
Last Update Date2016-06-09
Business Address
-- WANDERFUL PORTER FNP-BC
602 BRUNSON DR
TUPELO, MS 38801-4947
Phone number: 662-680-3855
Mailing Address
-- WANDERFUL PORTER FNP-BC
602 BRUNSON DR
TUPELO, MS 38801-4947
Phone number: 662-680-3855
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