Individual
GLADYS CARLA STATEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 KYLE DR STE 2, HOUSTON, MS 38851-2717
(662) 794-2878
(662) 456-1269
Mailing address
PO BOX 148, HOUSTON, MS 38851-0148
(662) 794-2878
(662) 456-1269
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1168
MS
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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