Individual
MS. LAUREN A SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 ASU DR, #510, LORMAN, MS 39096-7500
(601) 877-2483
(601) 877-3821
Mailing address
1000 ASU DR, #510, LORMAN, MS 39096-7500
(601) 877-2483
(601) 877-3821
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0629
MS
Other
Enumeration date
12/30/2012
Last updated
12/30/2012
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