Individual
MATUSALA TESFAI YOUHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5012
Mailing address
5084 SAVANNAH PKWY, SOUTHAVEN, MS 38672-7512
(901) 308-9379
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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