Individual
MR. STEPHEN ROSS JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1707 S COLORADO ST STE A, GREENVILLE, MS 38703-7275
(662) 335-8332
(662) 335-8852
Mailing address
1707 S COLORADO ST STE A, GREENVILLE, MS 38703-7275
(662) 335-8332
(662) 335-8852
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1045
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9015486
—
MS
Enumeration date
05/15/2007
Last updated
07/09/2007
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