Individual
STACY WHITED MANSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 308-5117
(601) 308-5103
Mailing address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 308-5117
(601) 308-5103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3654
MS
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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