Organization
THE MEDICAL TECHNOLOGY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN REGINAL (OWNER/CEO)
(662) 931-3645
Entity
Organization
Contact information
Practice address
810 E SUNFLOWER RD, SUITE J, CLEVELAND, MS 38732-2800
(662) 931-3645
Mailing address
810 EAST SUNFLOWER ROAD, SUITE J, CLEVELAND, MS 38732
(662) 931-3645
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/27/2013
Last updated
03/27/2013
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