Jla Senior Footcare Ms LLC
NPI #1508161597 in Petal, Mississippi
Provider Information
- NPI Number
- 1508161597
- Entity Type
- Organization
- Organization Name
- Jla Senior Footcare Ms LLC
- Primary Specialty
- Podiatrist - Foot Surgery
- Enumeration Date
- Jan 21, 2011
- Last Updated
- Jan 21, 2011
Practice Location
- Address
- 300 ARK LN
- City
- Petal
- State
- Mississippi
- ZIP Code
- 39465-3606
- Phone
- (330) 702-0978
Authorized Official
- Name
- ANTHONY INNOCENZI
- Title
- OWNER
- Phone
- (330) 702-0978
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist - Foot Surgery — Foot Surgery |
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