Jea Optical LLC
NPI #1215491014 in Madison, Mississippi
Provider Information
- NPI Number
- 1215491014
- Entity Type
- Organization
- Organization Name
- Jea Optical LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jan 25, 2019
- Last Updated
- Jan 25, 2019
Practice Location
- Address
- 401 BAPTIST DR STE 201
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110-2009
- Phone
- (601) 853-2020
Authorized Official
- Name
- ROBERT AMORY MALLETTE, MD
- Title
- MANAGING PARTNER
- Phone
- (601) 353-2020
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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