DEEDRA BRACKEEN FONTANA

INDIANOLA, MS
NPI1972103455
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: MS  e-8028)
Enumeration Date2020-10-26
Last Update Date2020-10-26
Business Address
DEEDRA BRACKEEN FONTANA rph
633 HIGHWAY 82 W
INDIANOLA, MS 38751-2078
Phone number: 662-887-3788
Mailing Address
DEEDRA BRACKEEN FONTANA rph
45 GOWER LN
LELAND, MS 38756-9480
Phone number: 662-822-4654
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