Individual
MS. VICKIE LEONA WALTERS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
433 BROAD ST, COLUMBIA, MS 39429-3038
(601) 444-0030
Mailing address
1485 BROWNS BRIDGE RD, HATTIESBURG, MS 39401-8739
(601) 434-9361
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3440
MS
Other
Enumeration date
06/05/2006
Last updated
07/08/2007
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