Individual
PETER BRIAN DEROUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
160 INDUSTRIAL PKWY STE 105, LAFAYETTE, LA 70508-8309
(337) 298-0990
Mailing address
PO BOX 61592, LAFAYETTE, LA 70596-1592
(337) 214-0779
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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