MR. Matthew Manuel Carrillo, OWNER
NPI #1356386288 in Laurel, Mississippi
Provider Information
- NPI Number
- 1356386288
- Entity Type
- Individual
- Name
- MR. Matthew Manuel Carrillo, OWNER
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist - Prosthetics Case Management
- Credential
- OWNER
- Enumeration Date
- Jun 17, 2006
- Last Updated
- Nov 7, 2007
Practice Location
- Address
- 434 S 13TH AVE
- City
- Laurel
- State
- Mississippi
- ZIP Code
- 39440-4345
- Phone
- (601) 649-0001
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist - Prosthetics Case Management — Prosthetics Case Management |
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