Provider First Line Business Practice Location Address:
4381 SOUTH EASON BLVD., SUITE 303
Provider Second Line Business Practice Location Address:
NORTH MISSISSIPPI SPORTS MEDICINE AND ORTHOPAEDIC CLINI
Provider Business Practice Location Address City Name:
TUPELO
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-840-5747
Provider Business Practice Location Address Fax Number:
662-840-5856
Provider Enumeration Date:
12/04/2008