Individual
HEATHER STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 MEDICAL BLVD, HATTIESBURG, MS 39401-7230
(601) 250-4815
Mailing address
315 N MAIN ST, POPLARVILLE, MS 39470-2315
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3854
MS
Other
Enumeration date
09/16/2008
Last updated
09/30/2008
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