Individual
MISS JEANIE BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1802 STRONG AVE, GREENWOOD, MS 38930-3910
(662) 392-5599
(662) 459-7139
Mailing address
1308 MAGNOLIA ST, GREENWOOD, MS 38930-2222
(662) 453-5681
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0233
MS
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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