Individual
CAROL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4387 LEISURE TIME DR, DIAMONDHEAD, MS 39525-3242
(228) 255-3533
(228) 255-3536
Mailing address
PO BOX 7066, GULFPORT, MS 39506-7066
(228) 354-9460
(228) 354-9462
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5845
MS
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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