Individual
MRS. PENNY J STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
9 COUNTY ROAD 7012, BOONEVILLE, MS 38829-8250
(662) 728-1552
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3285
MS
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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