La Miss Diabetic Shoes
NPI #1023478435 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1023478435
- Entity Type
- Organization
- Organization Name
- La Miss Diabetic Shoes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Feb 26, 2016
- Last Updated
- Feb 26, 2016
Practice Location
- Address
- 2200 HIGHWAY 61 N
- Address 2
- SUITE 3400
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39183-8246
- Phone
- (601) 883-3342
Authorized Official
- Name
- MRS. STEPHANIE F PHELAN, DPM
- Title
- OWNER/PROVIDER
- Phone
- (601) 883-3342
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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