Individual
KIRK WHARTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3311 SHADOW HILL DR, BATON ROUGE, LA 70816-3791
(504) 250-4172
Mailing address
3311 SHADOW HILL DR, BATON ROUGE, LA 70816-3791
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
210896
LA
Other
Enumeration date
08/17/2009
Last updated
08/17/2009
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