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1649554890
STACY L HOLDER
SOUTHAVEN, MS
NPI
1649554890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MS PTA4995)
Enumeration Date
2011-10-06
Last Update Date
2011-10-06
Business Address
STACY L HOLDER PTA09
83 AIRWAYS PL
SOUTHAVEN, MS 38671-5885
Phone number: 662-349-8787
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Mailing Address
STACY L HOLDER PTA09
83 AIRWAYS PL
SOUTHAVEN, MS 38671-5885
Phone number: 662-349-8787
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