Individual
JEVORIUS K PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 SCHOOL HOUSE LN, DE KALB, MS 39328-9469
(601) 479-3399
Mailing address
150 SCHOOL HOUSE LN, DE KALB, MS 39328-9469
(601) 479-3399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3119
MS
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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