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1013276153
DOMINICK DIECIDUE
METAIRIE, LA
NPI
1013276153
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA RN108985)
Enumeration Date
2012-05-10
Last Update Date
2012-05-10
Business Address
DOMINICK DIECIDUE CRNA
3510 N CAUSEWAY BLVD SUITE 404
METAIRIE, LA 70002-3531
Phone number: 504-779-5515
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Mailing Address
DOMINICK DIECIDUE CRNA
255 W MICHIGAN AVE PO BOX 1123
JACKSON, MI 49201-2218
Phone number: 517-787-6440
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