Individual
MARY GWINDOLYN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 E SAINT MARY AVE, POTTS CAMP, MS 38659-4400
(662) 544-1834
Mailing address
130 E SAINT MARY AVE, POTTS CAMP, MS 38659-4400
(662) 544-1834
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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