Individual
STACY MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 MEDICAL CENTER DR, BATESVILLE, MS 38606-8608
(662) 712-7721
Mailing address
2689 STRIDER RD, SCOBEY, MS 38953-9527
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2118
MS
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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