SearchMississippi246ZC0007X

Keneen Childress, C.S.A

NPI 1396289203 · on the registry since 2016 · sole proprietor

Practice

Address
12035 Springridge Rd
Terry, MS 39170
Phone
(601) 527-6290

Registry record

Primary taxonomy
246ZC0007X
246ZC0007X
Licence states on file
MS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-12-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi