Individual
LATOYA BRAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6525
Mailing address
440 E WOODROW WILSON AVE, JACKSON, MS 39216-4526
(601) 984-6525
(601) 815-0334
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
000000000
MS
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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