Individual
KIRK L LANDRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 MASON ST, LAUREL, MS 39440-4437
(601) 399-0547
(601) 425-7585
Mailing address
43 LANDRUM RD, OVETT, MS 39464-3735
(601) 319-5879
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0177
MS
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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