Individual
MRS. MARI JANE BOSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
712 N CHRISMAN AVE, SUTIE C, CLEVELAND, MS 38732-2107
(662) 843-3004
(662) 843-0820
Mailing address
712 N CHRISMAN AVE, SUTIE C, CLEVELAND, MS 38732-2107
(662) 843-3004
(662) 843-0820
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1494
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117948
—
MS
Enumeration date
07/19/2006
Last updated
11/09/2010
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