Individual
JESSICA GAIL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
813 W THIRD ST, FOREST, MS 39074-4006
(601) 469-1001
(601) 469-1009
Mailing address
PO BOX 426, MAGEE, MS 39111-0426
(601) 849-6440
(601) 849-7557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3789
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06584588
—
MS
Enumeration date
11/13/2006
Last updated
07/08/2007
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