Individual
JACENTA MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1435 N FRONTAGE RD, VICKSBURG, MS 39180-5170
(601) 661-9652
Mailing address
1842 TITA ST, NEW ORLEANS, LA 70114-3383
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E15632
MS
183500000X
Pharmacist
Primary
PST.022886
LA
Other
Enumeration date
10/22/2018
Last updated
09/18/2020
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