Individual
JACOB ROVIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 867-4000
Mailing address
612 METAIRIE LAWN DR, METAIRIE, LA 70001
(504) 296-9301
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/09/2024
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