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Individual

MICHAEL ALEXANDER PANNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
1670 MCCLURE CV, TUPELO, MS 38804-1209
(662) 205-8171
Mailing address
1670 MCCLURE CV, TUPELO, MS 38804-1209
(662) 205-8171

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3686
MS
225XH1200X
Hand Occupational Therapist
5145
AL

Other

Enumeration date
03/25/2020
Last updated
03/12/2026
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