Individual
LADAMIYA FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 PARISH RD, THIBODAUX, LA 70301-2244
(337) 591-5001
Mailing address
510 PARISH RD, THIBODAUX, LA 70301-2244
(337) 591-5001
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
008416027
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
474023425
FEDERAL TAX ID
LA
Enumeration date
12/04/2015
Last updated
12/04/2015
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