Individual
WINONA FARREN WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8748 QUARTERS LAKE RD, BATON ROUGE, LA 70809
(225) 928-8686
Mailing address
8748 QUARTERS LAKE RD, BATON ROUGE, LA 70809
(225) 928-8686
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LA4315
LA
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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