Individual
REBECCA SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
108 VETERANS MEMORIAL DR, KOSCIUSKO, MS 39090-3849
(769) 777-4400
(768) 777-4401
Mailing address
203 W JEFFERSON ST, KOSCIUSKO, MS 39090-3620
(769) 777-4400
(768) 777-4401
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6468
MS
Other
Enumeration date
07/28/2020
Last updated
09/15/2021
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