| NPI | 1497396931 |
|---|---|
| Doing Business As | ORTHOXPRESS OF SOUTHAVEN |
| Entity Type | Organization |
| Authorized Contact | JENNIFER C BULLOCK President 662-534-2227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2023-06-27 |