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1205527819
BRANTLEY BOOTH
LAKE CHARLES, LA
NPI
1205527819
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA 230060)
Enumeration Date
2023-05-16
Last Update Date
2023-09-14
Business Address
BRANTLEY BOOTH PMHNP
2829 4TH AVE STE 150
LAKE CHARLES, LA 70601-7897
Phone number: 337-480-7800
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Mailing Address
BRANTLEY BOOTH PMHNP
2829 4TH AVE STE 150
LAKE CHARLES, LA 70601-7897
Phone number: 337-477-7091
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