Individual
MELINDA A WEISENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
4600 W NORTHSIDE DRIVE, CLINTON, MS 39056
(601) 668-6064
Mailing address
4600 W NORTHSIDE DR, CLINTON, MS 39056-9699
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0203
MS
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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