Individual
MR. LEVI JAKE DALTON STONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2483
(504) 842-3000
Mailing address
123 OLDFIELD CIR, SYLACAUGA, AL 35150-6579
(256) 872-0547
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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