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1205578879
CHARLESTON WEST
JEFFERSON, LA
NPI
1205578879
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-12
Last Update Date
2022-04-12
Business Address
-- CHARLESTON WEST
1514 JEFFERSON HWY
JEFFERSON, LA 70121-2429
Phone number: 866-624-7637
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Mailing Address
-- CHARLESTON WEST
1514 JEFFERSON HWY
JEFFERSON, LA 70121-2429
Phone number:
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