Individual
MRS. JESSICA MCCULLY GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
702 HIGHWAY 82 WEST, SUITE B, GREENWOOD, MS 38930
(662) 455-5010
Mailing address
1529 DESOTO STREET APT #8, GREENWOOD, MS 38930
(662) 299-3512
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4679
MS
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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