Individual
YONETTE MACOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 RAYMOND RD, JACKSON, MS 39204-4203
(601) 371-1700
Mailing address
1600 RAYMOND RD, JACKSON, MS 39204-4203
(601) 371-1700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 3829
MS
Other
Enumeration date
02/17/2013
Last updated
02/17/2013
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