Individual
MR. GARRICK L MAYWEATHER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15625 COUNCIL AVE, BATON ROUGE, LA 70817-5502
(225) 205-7181
Mailing address
15625 COUNCIL AVE, BATON ROUGE, LA 70817-5502
(225) 205-7181
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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