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Individual

HEALY VISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5012
Mailing address
3545 EDMAR PL, JACKSON, MS 39216-3515
(601) 720-8868

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
02/15/2024
Last updated
02/15/2024
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