Individual
MR. FREDERICK BERNARD REGINAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2310 HIGHWAY 80 W, JACKSON, MS 39204-2354
(769) 251-1106
(769) 251-1106
Mailing address
2310 HIGHWAY 80 W, JACKSON, MS 39204-2354
(769) 251-1106
(769) 251-1106
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/20/2018
Last updated
11/20/2018
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