Provider Demographics
NPI:1356663199
Name:FRANKLIN, ECLECIUS LE'MON SR
Entity type:Individual
Prefix:MR
First Name:ECLECIUS
Middle Name:LE'MON
Last Name:FRANKLIN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 N STATE ST
Mailing Address - Street 2:B-4
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4233
Mailing Address - Country:US
Mailing Address - Phone:601-366-7800
Mailing Address - Fax:
Practice Address - Street 1:2906 N STATE ST
Practice Address - Street 2:B4
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-366-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSLMT464225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist