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1912539115
COLBY RYAN THIBODEAUX
LAKE CHARLES, LA
NPI
1912539115
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: LA 211814)
Enumeration Date
2020-02-06
Last Update Date
2022-04-28
Business Address
MR. COLBY RYAN THIBODEAUX FNP
4345 NELSON RD STE 101
LAKE CHARLES, LA 70605-4183
Phone number: 337-480-7942
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Mailing Address
MR. COLBY RYAN THIBODEAUX FNP
PO BOX 122165 DEPT 2165
DALLAS, TX 75312-2162
Phone number: 337-494-2921
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