Individual
LETESHA SEALS MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
968 S GLOSTER ST, TUPELO, MS 38801-6346
(662) 841-2900
Mailing address
114 DRIVE 561, SHANNON, MS 38868-9093
(662) 401-7716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
897542
MS
Other
Enumeration date
03/06/2021
Last updated
03/06/2021
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