Individual
MARY MICHELLE DUKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
(662) 349-8787
Mailing address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTA7667
MS
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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