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Individual

JUSTIN MCELROY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
6947 CRUMPLER BLVD, OLIVE BRANCH, MS 38654-1922
(662) 893-3300
(662) 893-3301
Mailing address
6947 CRUMPLER BLVD, OLIVE BRANCH, MS 38654-1922
(662) 893-3300
(662) 893-3301

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
962
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
962
MISSISSIPPI STATE BOARD OF OPTOMETRY
MS
Enumeration date
07/19/2017
Last updated
07/21/2022
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