Individual
CAROLYN B BOHNSACK SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 607-1415
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 607-1415
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4490
MS
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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