Individual
MRS. JENNIFER MARDIS DURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5600 GOODMAN RD STE D, OLIVE BRANCH, MS 38654-7002
(662) 895-4545
(662) 895-4545
Mailing address
5600 GOODMAN RD STE D, OLIVE BRANCH, MS 38654-7002
(662) 895-4545
(662) 895-4545
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3716
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05101748
—
MS
Enumeration date
07/23/2006
Last updated
07/08/2007
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