Individual
MR. GERALD JULES DECLOUET JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
4190 GERSTNER MEMORIAL BLVD, LAKE CHARLES, LA 70607-3804
(337) 240-9730
Mailing address
1308 JEFFERSON DR, LAKE CHARLES, LA 70605-5540
(337) 853-0770
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z11817
LA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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