Individual
ALEXANDER ROYALE MAZIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1109 CARTER ST STE 10, VIDALIA, LA 71373-3227
(318) 336-4700
(318) 336-4777
Mailing address
511 N UNION ST, NATCHEZ, MS 39120-2946
(601) 597-3257
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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