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1710144902
MICHAEL PROCTOR
MONROE, LA
NPI
1710144902
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 204759)
Enumeration Date
2008-05-16
Last Update Date
2016-10-06
Business Address
-- MICHAEL PROCTOR
4864 JACKSON ST
MONROE, LA 71202-6400
Phone number: 318-333-0703
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Mailing Address
-- MICHAEL PROCTOR
2015 ROSEDOWN DR
MONROE, LA 71201-3084
Phone number: 318-355-8874
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