Individual
JESSICA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1310 ASTON AVE, MCCOMB, MS 39648-2826
(601) 250-5517
Mailing address
1310 ASTON AVE, MCCOMB, MS 39648-2826
(601) 250-5517
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4133
MS
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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