Individual
MRS. JENNIFER S MCGAVOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T
Contact information
Practice address
50 S MAIN ST, WATER VALLEY, MS 38965-2946
(662) 473-4777
(662) 473-2233
Mailing address
50 S MAIN ST, WATER VALLEY, MS 38965-2946
(662) 473-3400
(662) 473-4389
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1855
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119837
—
MS
Enumeration date
06/18/2006
Last updated
07/08/2007
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