Individual
JACOLBY CHRISTOPHER JIRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 W VINE ST, OPELOUSAS, LA 70570-5153
(337) 326-4568
Mailing address
119 W VINE ST, OPELOUSAS, LA 70570-5153
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
LA
Enumeration date
12/04/2019
Last updated
01/15/2021
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