| NPI | 1407699309 |
|---|---|
| Doing Business As | FOOT CARE ETC LLC |
| Entity Type | Organization |
| Authorized Contact | GLORIA JEAN JACKSON Owner 601-934-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |