Individual
MRS. TRACEY BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 ROSEWOOD ST, JACKSON, MS 39212-3966
(601) 383-5815
Mailing address
1160 ROSEWOOD ST, JACKSON, MS 39212-3966
(601) 383-5815
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1212995
MS
Other
Enumeration date
06/04/2020
Last updated
07/09/2020
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