Individual
STACY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
156 E WALNUT AVE, EUPORA, MS 39744-2027
(662) 258-8293
Mailing address
156 E WALNUT AVE, EUPORA, MS 39744-2027
(662) 258-8293
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0267
MS
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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