Shalisa Gaines
NPI #1033659958 in Clinton, Mississippi
Provider Information
- NPI Number
- 1033659958
- Entity Type
- Individual
- Name
- Shalisa Gaines
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Contractor
- Enumeration Date
- Feb 24, 2017
- Last Updated
- Feb 24, 2017
Practice Location
- Address
- 608 HIGHWAY 80 E # C
- City
- Clinton
- State
- Mississippi
- ZIP Code
- 39056-5104
- Phone
- (769) 218-0292
Specialties & Taxonomy Codes
| Specialty |
|---|
| Contractor |
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