Individual
LAURA MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Mailing address
42 KITE WAY, STARKVILLE, MS 39759-4444
(662) 299-2496
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
OT2337
MS
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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