Individual
MRS. NICHOLE R FUTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
19 BASS RD, PINEVILLE, LA 71360-9121
(318) 451-5857
Mailing address
19 BASS RD, PINEVILLE, LA 71360-9121
(318) 451-5857
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11357
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527955
—
LA
Enumeration date
04/17/2007
Last updated
07/09/2007
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