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Organization
DR. GLENN M COULLARD
Active
Organization
DR. GLENN M COULLARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE MARIE LOEBS (OFFICE MANAGER)
(225) 324-5190
Entity
Organization
Contact information
Practice address
11937 FERDINAND STREET, SAINT FRANCISVILLE, LA 70775-4342
(225) 635-6483
(225) 658-2424
Mailing address
156 GOLDEN MEADOW DR, COVINGTON, LA 70433-6604
(225) 938-7701
(225) 658-2424
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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