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1144760414
MARY MANCUSO HEAROD
LAKE CHARLES, LA
NPI
1144760414
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA AP09122)
Enumeration Date
2017-03-06
Last Update Date
2022-04-27
Business Address
MARY MANCUSO HEAROD N.P.
2770 3RD AVE STE 345
LAKE CHARLES, LA 70601-8994
Phone number: 337-494-4785
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Mailing Address
MARY MANCUSO HEAROD N.P.
PO BOX 122623 DEPT 2623
DALLAS, TX 75312-2623
Phone number: 337-494-2921
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