Individual
MICHAEL CHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1990 S FRONTAGE RD STE J, VICKSBURG, MS 39180-5232
(601) 883-1983
(601) 883-1938
Mailing address
1990 S FRONTAGE RD STE J, VICKSBURG, MS 39180-5232
(601) 883-1983
(601) 883-1938
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA5298
MS
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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