Individual
MRS. ERICA BROOKE WEDGWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3716 HIGHWAY 39 N, MERIDIAN, MS 39301-1013
(601) 482-7164
Mailing address
5135 ZERO RD, MERIDIAN, MS 39301-9294
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6507
MS
Other
Enumeration date
01/05/2022
Last updated
01/05/2022
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