Individual
BRITTANI BOATWRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
278 W 8TH ST, PONTOTOC, MS 38863-3612
(662) 489-6411
Mailing address
180 NORTH MAIN STREET, PONTOTOC, MS 38863
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4524
MS
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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