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1104806124
CARL G MALLETT
LAKE CHARLES, LA
NPI
1104806124
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA 03828)
Enumeration Date
2006-01-17
Last Update Date
2010-09-22
Business Address
CARL G MALLETT CRNA
1128 HIDDEN OAK LN
LAKE CHARLES, LA 70605-7123
Phone number: 337-478-1085
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Mailing Address
CARL G MALLETT CRNA
1128 HIDDEN OAK LN
LAKE CHARLES, LA 70605-7123
Phone number: 337-478-1085
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