Individual
MADELINE GRACE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 MARSHALL ST STE 400, JACKSON, MS 39202-1687
(601) 354-0869
Mailing address
501 MARSHALL ST STE 400, JACKSON, MS 39202-1687
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00312
MS
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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