Organization
ROME SHERROD II
Active
Other names
Tri-State Healthcare For Women
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERICA MONTGOMERY (OFFICE MANAGER)
(622) 342-1005
Entity
Organization
Contact information
Practice address
835 BRANDYWINE DR, #102, SOUTHAVEN, MS 38671-2434
(662) 342-1005
(662) 342-0280
Mailing address
835 BRANDYWINE DRIVE, #102, SOUTHAVEN, MS 38671-2424
(662) 342-1005
(662) 342-0280
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
9374
MS
Other
Enumeration date
04/18/2007
Last updated
06/18/2008
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