Individual
JACKLYN DANISE WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
744 CORINTH RD, PURVIS, MS 39475-4450
(601) 731-4567
Mailing address
744 CORINTH RD, PURVIS, MS 39475-4450
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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