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1861044554
IHIANLE OSAGIE
MONROE, LA
NPI
1861044554
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 331863)
Enumeration Date
2019-07-12
Last Update Date
2024-02-22
Business Address
IHIANLE OSAGIE
4864 JACKSON ST
MONROE, LA 71202-6400
Phone number: 318-330-7615
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Mailing Address
IHIANLE OSAGIE
4864 JACKSON ST
MONROE, LA 71202-6400
Phone number: 318-330-7615
Copy
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