Individual
MONGKON SMELSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
12603 HIGHWAY 57, VANCLEAVE, MS 39565-7420
(228) 283-5083
Mailing address
PO BOX 5667, VANCLEAVE, MS 39565-5667
(228) 283-5083
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
823
MS
225700000X
Massage Therapist
Primary
823
MS
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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