Individual
MELISSA FORTINBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
709 ROBB STREET, SUMMIT, MS 39666
(601) 248-8019
Mailing address
PO BOX 1358, SUMMIT, MS 39666-1301
(601) 248-8019
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2169
MS
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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