Individual
JACY LEE MCPHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2791 COUNTY ROAD 89, FORT PAYNE, AL 35967-6147
(256) 630-1279
Mailing address
2791 COUNTY ROAD 89, FORT PAYNE, AL 35967-6147
(256) 630-1279
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12760
AL
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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