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Technologists, Technicians & Other Technical Service Providers Specialist/Technologist Cardiovascular

Provider NPI: 1164567541

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
3311 PRESCOTT RD STE 202  ALEXANDRIA, LA 71301-3983 US
Tel: 318-442-0106  Fax: 318-442-8151

Business Mailing Address:
1260 LAKE DR  WOODWORTH, LA 71485-9728 US
Tel: 318-487-4080  Fax: --

NPI Information:
NPI: 1164567541
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y246X00000XTechnologists, Technicians & Other Technical Service Providers
Specialist/Technologist Cardiovascular

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 246X00000X





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