Individual
LATERICA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12764 WARWICK AVE, BATON ROUGE, LA 70815-6860
(225) 610-3410
Mailing address
12764 WARWICK AVE, BATON ROUGE, LA 70815-6860
(225) 610-3410
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20170146
LA
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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