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Individual

MR. EMILE J CROUCHET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
109 HARRISON DR, LAFAYETTE, LA 70507-5523
(337) 207-1626
Mailing address
109 HARRISON DR, LAFAYETTE, LA 70507-5523
(337) 207-1626

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
006138892
LA
343900000X
Non-emergency Medical Transport (VAN)
006138892
LA

Other

Enumeration date
01/31/2019
Last updated
10/09/2019
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