TED ETELL FONTENOT

LAKE CHARLES, LA
NPI1598052052
Former NameTED ETELL FONTENOT
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner Adult Health
(Licence: LA  AP06448)
Enumeration Date2011-07-06
Last Update Date2022-04-27
Business Address
MR. TED ETELL FONTENOT ANP
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601-8990
Phone number: 337-494-3278
Mailing Address
MR. TED ETELL FONTENOT ANP
PO BOX 122152 DEPT 2152
DALLAS, TX 75312-0001
Phone number: 337-494-2921
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