Individual
IDA MARIE COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3261 HIGHWAY 49, COLLINS, MS 39428-3876
(601) 921-6043
(601) 921-6044
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1673
MS
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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