Individual
MICHELLE MONTET GARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 262-4160
Mailing address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 262-4160
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
900781
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337045
—
LA
Enumeration date
05/31/2018
Last updated
06/16/2018
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