SearchMississippi3747P1801X

Lawrence Self

NPI 1811534472 · on the registry since 2019 · sole proprietor

Practice

Address
19150 Highway 61 N
Lyon, MS 38645
Phone
(662) 902-4614

Registry record

Primary taxonomy
3747P1801X
3747P1801X
Licence states on file
MS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-12-03

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