RAYMOND WALLACE

MANDEVILLE, LA
NPI1568821874
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164X00000X Licensed Vocational Nurse
(Licence: LA  20101002)
Enumeration Date2016-02-15
Last Update Date2016-02-15
Business Address
Mr. RAYMOND WALLACE LPN
23861 SOUTH ROBIN RD
MANDEVILLE, LA 70448
Phone number: 985-624-4100
Mailing Address
Mr. RAYMOND WALLACE LPN
PO BOX 37
MANDEVILLE, LA 70470-0037
Phone number: