person
Mr. Matthew Manuel Carrillo, OWNER
Prosthetics Case Management in Laurel, Mississippi
NPI 1356386288

Matthew Manuel Carrillo is a Prosthetics Case Management based in Laurel, MS and is specialized in Prosthetics Case Management. Matthew Manuel Carrillo practices in Laurel, MS and has the professional credentials of OWNER. The NPI Number for Matthew Manuel Carrillo is 1356386288 and holds a License No. 07014/11.1 (Mississippi).

The current practice location address for Matthew Manuel Carrillo is 434 S 13Th Ave, Laurel, MS and can be reached out via phone at 601-649-0001 and via fax at 601-649-0035. You can also correspond with Matthew Manuel Carrillo through the mailing address at PO BOX 6501, LAUREL, MS - 39441-6501 (mailing address contact number: 601-649-0001).

Location: 434 S 13Th Ave, Laurel, MS, 39441-6501
person
Provider Profile Details
NPI Number
1356386288
Provider Name
Matthew Manuel Carrillo
Credential
OWNER
Provider Entity Type
Individual
Gender
Male
Address
434 S 13Th Ave, Laurel, MS, 39441-6501
Phone Number
601-649-0001
Fax Number
601-649-0035
Provider Enumeration Date
06/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01339261 05 MS
institution
Provider Business Practice Location Address Details
Address
434 S 13Th Ave
City
State
Zip
39440-4345
Phone Number
601-649-0001
Fax Number
601-649-0035
person
Provider Business Mailing Address Details
Address
434 S 13Th Ave
City
State
Zip
39440-4345
Phone Number
601-649-0001
Fax Number
601-649-0035
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
Prosthetics Case Management
Taxonomy
License No.
07014/11.1 (Mississippi)
Definition
Definition to come...
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