Individual
MR. TERRY MARK WINSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1058 HOLLAND AVE, PHILADELPHIA, MS 39350-9121
(601) 656-2776
Mailing address
1058 HOLLAND AVE, PHILADELPHIA, MS 39350-9121
(601) 656-2776
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0928
MS
Other
Enumeration date
10/03/2006
Last updated
10/10/2012
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