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1902450851
JED MICHAEL GUILLORY
LAKE CHARLES, LA
NPI
1902450851
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 207008)
Enumeration Date
2019-07-29
Last Update Date
2019-07-29
Business Address
JED MICHAEL GUILLORY FNP-C
1701 OAK PARK BLVD
LAKE CHARLES, LA 70601-8911
Phone number: 337-494-3000
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Mailing Address
JED MICHAEL GUILLORY FNP-C
4788 W NICK CLAIRE LN
IOWA, LA 70647-5148
Phone number: 337-488-6843
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