JERRY V RIDGE

LAUREL, MS
NPI1447482237
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MS  AD01R-019R)
Enumeration Date2009-08-13
Last Update Date2009-08-13
Business Address
-- JERRY V RIDGE MADAC
7 LINE RD
LAUREL, MS 39443-2663
Phone number: 601-705-1901
Mailing Address
-- JERRY V RIDGE MADAC
7 LINE RD
LAUREL, MS 39443-2663
Phone number: 601-705-1901
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