Individual
ISAIAH MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 COLLEGE DR, HATTIESBURG, MS 39406-0001
(601) 880-0909
Mailing address
142 DAVIS RD, LITTLE ROCK, MS 39337-9240
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/05/2021
Last updated
09/01/2022
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