Individual
SALLIE HUMPHREYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
1170 COUNTY ROAD 180, BLUE SPRINGS, MS 38828-9268
(662) 507-5146
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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