Individual
FELECIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 HIGHWAY 80 W, JACKSON, MS 39204-2354
(601) 899-2445
Mailing address
652 WILDFIRE WAY, JACKSON, MS 39209-6020
(601) 899-2445
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
05/04/2020
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