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Organization

WAYMAKER ENTERPRISES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASMINE MARTIN SMITH PT, DPT (CEO)
(601) 940-4669
Entity
Organization

Contact information

Practice address
204 BRADFIELD RD, MADISON, MS 39110-7035
(601) 940-4669
Mailing address
PO BOX 68071, JACKSON, MS 39286-8071

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
05/06/2020
Last updated
05/06/2020
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