Individual
KIM T STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 MARYLAND AVE, MCCOMB, MS 39648-3926
(601) 250-4815
(601) 250-6859
Mailing address
2133A RUSSELL MOUNT GILEAD RD, MERIDIAN, MS 39301-8334
(601) 250-4815
(601) 250-6859
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA0795
MS
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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