Individual
KATIE VINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 GOODMAN RD E, SOUTHAVEN, MS 38672-9073
(662) 772-5859
(662) 772-5860
Mailing address
2945 GOODMAN RD E, SOUTHAVEN, MS 38672-9073
(662) 772-5859
(662) 772-5860
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-15544
MS
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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