Individual
DEREK MITCHELL JAMBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 FALCONER DR STE D, COVINGTON, LA 70433-8211
(985) 900-2305
(985) 900-2306
Mailing address
330 FALCONER DR STE D, COVINGTON, LA 70433-8211
(985) 900-2305
(985) 900-2306
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A09506
LA
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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