Individual
JOSEPH CORBIN PRESTIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
18540 WHITE OAK DR, PRAIRIEVILLE, LA 70769-3737
(225) 802-8030
Mailing address
18540 WHITE OAK DR, PRAIRIEVILLE, LA 70769-3737
(225) 802-8030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200633
LA
Other
Enumeration date
06/12/2013
Last updated
07/01/2013
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