Individual
MS. BERNICE Y TOLBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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