Individual
MR. LARRY MCQUATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 MEADOWBROOK RD, JACKSON, MS 39206-5260
(601) 713-3366
(601) 713-3388
Mailing address
240 MEADOWBROOK RD, JACKSON, MS 39206-5260
(601) 713-3366
(601) 713-3388
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440848
—
MS
01
—
APP13354101
VGM -INSURANCE
MS
Enumeration date
04/06/2007
Last updated
03/21/2008
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