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1497872253
STANLEY MCCOLLOUGH
JACKSON, MS
NPI
1497872253
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2007-03-24
Last Update Date
2007-07-08
Business Address
-- STANLEY MCCOLLOUGH ATC, LAT, MHSA
1325 E FORTIFICATION ST
JACKSON, MS 39202-2442
Phone number: 601-354-4488
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Mailing Address
-- STANLEY MCCOLLOUGH ATC, LAT, MHSA
222 TURTLE CREEK DR
BYRAM, MS 39272-9793
Phone number:
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