Individual
JENNIFER CROWLEY REVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1039 MARTIN LUTHER KING DR, MARKS, MS 38646-1808
(662) 326-8609
(662) 326-3449
Mailing address
1039 MARTIN LUTHER KING DR, MARKS, MS 38646-1808
(662) 326-8609
(662) 326-3449
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-010718
MS
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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