IndividualActive
Amanda Williamson
NPI 1104598135 · Prosthetic/Orthotic Supplier · Jackson, MS
Provider details
- NPI number
- 1104598135
- Entity type
- Individual
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Suppliers
Practice location
115 N State St
Jackson, MS 39201-2811
Phone: (601) 918-4499
Approximate (ZIP-level) locationGet directions
Mailing address
115 N State St
Jackson, MS 39201-2811
Registry dates
- Enumerated
- 2021-09-28
- Last updated
- 2021-09-28
- Certified
- 2021-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.