Healthcare Provider Details

I. General information

NPI: 1386438489
Provider Name (Legal Business Name): JALYRICA MCFARLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 SPRINGRIDGE RD STE A
CLINTON MS
39056-5671
US

IV. Provider business mailing address

580 SPRINGRIDGE RD STE A
CLINTON MS
39056-5671
US

V. Phone/Fax

Practice location:
  • Phone: 601-397-7715
  • Fax:
Mailing address:
  • Phone: 601-398-5903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2767
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: