Individual
AMY MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
201 E LAYFAIR DR, SUITE 125, FLOWOOD, MS 39232-7604
(601) 420-6867
Mailing address
105 REDBUD DR, BRANDON, MS 39047-8461
(601) 594-1032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3161
MS
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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