Individual
ANTONIO MCCALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2575 RUSSUM DR, SOUTHAVEN, MS 38672-6564
(901) 649-2021
Mailing address
2575 RUSSUM DR, SOUTHAVEN, MS 38672-6564
(901) 649-2021
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5057
TN
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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