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1548017890
DEMONTE LEE ANDREW VANISON
SLIDELL, LA
NPI
1548017890
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2024-05-03
Last Update Date
2024-05-03
Business Address
DEMONTE LEE ANDREW VANISON
3773 CANAL BANK DR
SLIDELL, LA 70461-6646
Phone number: 985-402-9639
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Mailing Address
DEMONTE LEE ANDREW VANISON
3773 CANAL BANK DR
SLIDELL, LA 70461-6646
Phone number: 985-402-9639
Copy
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