Individual
MRS. ELIZABETH BRYCE MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
106 HIGHLAND WAY, SUITE 201, MADISON, MS 39110
(601) 790-9444
(601) 790-9446
Mailing address
106 HIGHLAND WAY, SUITE 201, MADISON, MS 39110
(601) 790-9444
(601) 790-9446
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT
MS
225100000X
Physical Therapist
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT4939
LICENSE
MS
Enumeration date
06/29/2011
Last updated
04/27/2016
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