Individual
MRS. JENNIFER STREET CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1010B CITY AVE N, RIPLEY, MS 38663-1413
(662) 512-0019
(662) 512-0430
Mailing address
PO BOX 972, NEW ALBANY, MS 38652-0972
(662) 512-0019
(662) 534-0430
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
855
MS
Other
Enumeration date
08/20/2012
Last updated
01/09/2014
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