Individual
BRIAN ROSS MASKEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4124 W 4TH ST APT 1606, HATTIESBURG, MS 39401-5710
(601) 264-2114
Mailing address
4124 W 4TH ST APT 1606, HATTIESBURG, MS 39401-5710
(601) 264-2114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0378
MS
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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