| Diberville Medical Spa | |
|
3661 Sangani Blvd Suite C Diberville MS 39540-8706 | |
| (228) 223-1927 | |
| Not Available |
| Full Name | Diberville Medical Spa |
|---|---|
| Speciality | Clinic/center |
| Location | 3661 Sangani Blvd, Diberville, Mississippi |
| Authorized Official Name and Position | Ronnie Ali (PRESIDENT) |
| Authorized Official Contact | 2282231927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diberville Medical Spa Po Box 1248 Ocean Springs MS 39566-1248 Ph: (228) 223-1927 | Diberville Medical Spa 3661 Sangani Blvd Suite C Diberville MS 39540-8706 Ph: (228) 223-1927 |
| NPI Number | 1861766289 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 03/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861766289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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