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Organization
SAPHENEIA MEDICAL MINIMALLY INVASIVE THERAPY INSTITUTE
Active
Organization
SAPHENEIA MEDICAL MINIMALLY INVASIVE THERAPY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A MANCILLA (CHIEF OPERATIONS OFFICER)
(601) 352-5663
Entity
Organization
Contact information
Practice address
932 N STATE ST, JACKSON, MS 39202-2613
(601) 352-5663
(601) 352-4437
Mailing address
932 N STATE ST, JACKSON, MS 39202-2613
(601) 352-5663
(601) 352-4437
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2006
Last updated
08/22/2020
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