Individual
STEPHANIE MCLARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
200 LONG ST, BOONEVILLE, MS 38829-4306
(662) 728-6234
Mailing address
200 LONG ST, BOONEVILLE, MS 38829-4306
(662) 728-6234
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4505
MS
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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