Individual
BARRETT WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 LONG ST, BOONEVILLE, MS 38829-4306
(662) 728-6234
Mailing address
200 LONG ST, BOONEVILLE, MS 38829-4306
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2834
MS
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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