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Organization
XCEPTIONAL HEALTH & WELLNESS, PLLC.
Active
Organization
XCEPTIONAL HEALTH & WELLNESS, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY F PETRIDES MD (OWNER/MD)
(662) 510-6507
Entity
Organization
Contact information
Practice address
5779 GETWELL RD, BLDG. D, SUITE 3, SOUTHAVEN, MS 38672-6347
(662) 510-6507
(662) 510-6508
Mailing address
5779 GETWELL RD, BLDG. D, SUITE 3, SOUTHAVEN, MS 38672-6347
(662) 510-6507
(662) 510-6508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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