Individual
MANDY WILLIAMS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
411 W NORTH ST, POPLARVILLE, MS 39470-2203
(601) 795-2130
(601) 795-2164
Mailing address
PO BOX 8419, BILOXI, MS 39535-8087
(228) 388-5714
(228) 388-0017
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4141
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090-15077
—
MS
01
—
1033218524
GROUP NPI
MS
Enumeration date
04/30/2007
Last updated
11/21/2008
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