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Organization
CARDIO-PULMONARY REHABILITATION (C.P.R.)
Active
Organization
CARDIO-PULMONARY REHABILITATION (C.P.R.)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWANDA S FANTROY APRN (CEO)
(228) 235-6015
Entity
Organization
Contact information
Practice address
11 N WATER ST STE 10290, MOBILE, AL 36602-5010
(228) 235-6015
Mailing address
4361 TERRACE DR, MOSS POINT, MS 39563-5635
(228) 235-6015
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
NULL
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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