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Individual

DAMON BAGLEY-AYRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
777 LAKELAND DR, JACKSON, MS 39216-4611
(601) 815-4844
(601) 815-4592
Mailing address
777 LAKELAND DR, JACKSON, MS 39216-4611
(601) 815-4844
(601) 815-4592

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary

Other

Enumeration date
10/13/2015
Last updated
06/09/2016
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