Individual
BETHANY POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4910 INTERSTATE 55 NORTH FRONTAGE RD, JACKSON, MS 39211
(601) 366-6554
Mailing address
4910 INTERSTATE 55 NORTH FRONTAGE RD, JACKSON, MS 39211
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
MSE-9443
MS
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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