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General NPI Number Information
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NPI Number | 1881219046
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Entity Type | Organization
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Legal Business Name | COLOR ME JAZZY
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Dates
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Enumeration Date | 06/13/2020
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Last Update Date | 06/13/2020
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Provider Practice Location Address
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Address Line | 665 S PEAR ORCHARD RD STE 106-560
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City | RIDGELAND
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State | MS
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Zip | 39157-4861
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Country | US
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Telephone | 662-207-5923
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Fax | 662-635-5155
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Provider Business Mailing Address
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Address Line | 665 S PEAR ORCHARD RD STE 106-560
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City | RIDGELAND
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State | MS
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Zip | 39157-4861
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Country | US
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Telephone | 662-207-5923
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Fax | 662-635-5155
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Authorized Official
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Title or Position | OWNER
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Name | JAZMINE COBB
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Credential |
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Telephone | 662-207-5923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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