Individual
KELLY EDMONDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1301A HARRISON AVE, MCCOMB, MS 39648
(601) 250-5455
Mailing address
1301A HARRISON AVE, MCCOMB, MS 39648
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/15/2009
Last updated
02/07/2017
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