Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Jan 28, 2020
License(s)
337759 (LA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 503 JACK MILLER RD STE 6 | Ville Platte, LA 70586-5607 | 337-363-9486 |
| MAILING | 9929 INTRODUCTION WAY | Orlando, FL 32832-6598 |
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