Individual
MR. KENDRA ALEXIS DEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5600 GOODMAN RD STE D, OLIVE BRANCH, MS 38654-7002
(662) 895-5454
(662) 895-4546
Mailing address
5600 GOODMAN RD STE D, OLIVE BRANCH, MS 38654-7002
(662) 895-5454
(662) 895-4546
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA2517
MS
Other
Enumeration date
07/23/2006
Last updated
07/08/2007
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