Individual
MRS. JOHNNIE MAE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA CHILD CARE CREDE
Contact information
Practice address
801 E NORTHSIDE DR, SUITE D, CLINTON, MS 39056-3663
(601) 906-1024
Mailing address
801 E NORTHSIDE DR, SUITE D, CLINTON, MS 39056-3663
(601) 906-1024
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
07/21/2011
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