Individual
AMANDA PERKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
174 TAZAN AVE, FLORENCE, MS 39073-8720
(601) 408-3503
Mailing address
174 TAZAN AVE, FLORENCE, MS 39073-8720
(601) 408-3503
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2719
MS
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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