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1740042589
TONY LEE SISTRUNK
JACKSON, MS
NPI
1740042589
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MS 901891)
Enumeration Date
2024-01-26
Last Update Date
2024-01-26
Business Address
TONY LEE SISTRUNK CRNA
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-815-2005
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Mailing Address
TONY LEE SISTRUNK CRNA
504 CLINTON CENTER DRIVE CBO SUITE 4300
CLINTON, MS 39056
Phone number: 601-815-2005
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