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Organization

SOUTHERN PROSTHETIC CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM J KENNY CP (OWNER)
(228) 216-0528
Entity
Organization

Contact information

Practice address
4201 HIGHWAY 11 N STE D, PICAYUNE, MS 39466
(228) 216-0528
(769) 242-2556
Mailing address
4201 HIGHWAY 11 N STE D, PICAYUNE, MS 39466-2014
(228) 216-0528
(769) 242-2556

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
08/22/2017
Last updated
07/21/2022
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