Carrillo, Matthew Manuel
Carrillo, Matthew Manuel is an sole proprietor health care provider with primary practice located at 434 S 13Th Ave , Laurel MS 39440-4345. He recently has only one registered license in Other Service Providers / Prosthetics Case Management, which is considered as his primary health care specialty. Carrillo, Matthew Manuel can be contacted via phone (601) 649-0001.Contact Information
Primary practice address
434 S 13Th Ave
Laurel MS 39440-4345
Phone: (601) 649-0001
Fax: (601) 649-0035
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prosthetics Case Management | 1744P3200X | 07014/11.1 | Mississippi |
Profile Details
| NPI number | 1356386288 |
|---|---|
| LBN Legal business name | Carrillo, Matthew Manuel |
| Credentials | OWNER |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 17th, 2006 |
| Last updated | Nov 7th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356386288 | NPPES |
| Mississippi | MEDICAID | 01339261 |
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