Individual
RONNIE MONSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2449 N FRONTAGE RD, VICKSBURG, MS 39180-5177
(601) 638-7905
Mailing address
2449 N FRONTAGE RD, VICKSBURG, MS 39180-5177
(601) 638-7905
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00089002
—
MS
Enumeration date
08/23/2006
Last updated
07/08/2007
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