Individual
TRAVIS THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
133 PINE ST, HAZLEHURST, MS 39083-2309
(601) 605-6777
(601) 894-9041
Mailing address
599C STEED RD, RIDGELAND, MS 39157-1707
(601) 605-6777
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3911
MS
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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