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1730477449
DIRCK ANTHONY GILLAM
NEW ORLEANS, LA
NPI
1730477449
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: LA 045476)
Enumeration Date
2011-07-14
Last Update Date
2011-07-15
Business Address
-- DIRCK ANTHONY GILLAM
145 ELK PL
NEW ORLEANS, LA 70112-2645
Phone number: 504-525-0918
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Mailing Address
-- DIRCK ANTHONY GILLAM
2401 DIVISION ST APT E34
METAIRIE, LA 70001-8805
Phone number: 504-975-7102
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