Individual
AMANDA WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 N STATE ST, JACKSON, MS 39201-2811
(601) 918-4499
Mailing address
115 N STATE ST, JACKSON, MS 39201-2811
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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