Individual
KELLY MICHELLE SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
300 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2349
(601) 833-7317
(601) 835-0995
Mailing address
300 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2349
(601) 833-7317
(601) 835-0995
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3648
MS
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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