Individual
SAMANTHA AYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 MAIN ST, SOUTHAVEN, MS 38671-1428
(901) 846-3092
Mailing address
4904 RICHARD PLACE CV, HORN LAKE, MS 38637-9601
(901) 846-3092
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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