Individual
EMMANUEL MBANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3402 BAKER BLVD # A-3, BAKER, LA 70714-2509
(225) 774-7476
Mailing address
3402 BAKER BLVD # A-3, BAKER, LA 70714-2509
(225) 774-7476
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15138
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1656968
—
LA
Enumeration date
06/04/2009
Last updated
07/01/2009
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