Individual
JOHNNY ELLIS VANHOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
(601) 276-3900
Mailing address
101 MILLS ST, BROOKHAVEN, MS 39601-2521
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3528
MS
Other
Enumeration date
05/05/2010
Last updated
05/05/2010
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