Individual
BRIDGET ELEASE SALLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 TURTLE CREEK DR, BYRAM, MS 39272-9422
(704) 499-0465
Mailing address
215 TURTLE CREEK DR, BYRAM, MS 39272-9422
(704) 499-0465
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
453632458
MS
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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