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1073757506
SHANE ERIN SANNE
JEFFERSON, LA
NPI
1073757506
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: LA DO.000223)
Enumeration Date
2009-04-28
Last Update Date
2016-11-23
Business Address
MR. SHANE ERIN SANNE
301 BROOKLYN AVE
JEFFERSON, LA 70121-2834
Phone number: 504-491-3902
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Mailing Address
MR. SHANE ERIN SANNE
301 BROOKLYN AVE
JEFFERSON, LA 70121-2834
Phone number: 504-491-3902
Copy
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