Individual
MR. WESLEY A FAVALORO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2640 N HIGHWAY 190, COVINGTON, LA 70433-9045
(985) 893-1916
(985) 893-1065
Mailing address
2640 N HIGHWAY 190, COVINGTON, LA 70433-9045
(985) 893-1916
(985) 893-1065
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/20/2007
Last updated
03/02/2011
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