Individual
MR. LEAVERN GUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.K.T.
Contact information
Practice address
925 CLOVER CIR, PICAYUNE, MS 39466-5436
(601) 273-1070
Mailing address
925 CLOVER CIR, PICAYUNE, MS 39466-5436
(601) 273-1070
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
1720
IL
Other
Enumeration date
09/01/2006
Last updated
01/08/2009
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