Individual
LAWRENCE MARVIN TIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
512 ROCKWELL DR, OKOLONA, MS 38860-1622
(662) 447-5777
(601) 607-1381
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT239
MS
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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