Individual
MRS. JENNIFER KOCH MEZICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3400
Mailing address
307 GAINES AVE, MOBILE, AL 36609-2460
(251) 463-3457
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
782
AL
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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