Most Relevant Information
Provider Data
| NPI Number: | 1003554197 |
| Provider Name: | JACOB CHARLES CARRELL |
| Entity Type: | Individual |
| Taxonomy Code: | 332B00000X |
| Specialty: | Durable Medical Equipment & Medical Supplies |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/26/2022 |
| Last Updated: | 05/26/2022 |
Provider Practice Location
421 W MAIN ST
SAFFORD
AZ
855462724
Practice Location Phone/Fax
| Phone: | 9283229166 |
| Fax: |
Provider Mailing Location
3450 N REED LN
SAFFORD
AZ
855469585
Provider Mailing Phone/Fax
| Phone: | 9283225493 |
| Fax: |