Individual
MR. LESLIE JOHN DAIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
808 BAYOU LN, THIBODAUX, LA 70301-4906
(985) 447-3164
Mailing address
101 ABBY RD, THIBODAUX, LA 70301-6016
(985) 446-1418
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00012R
LA
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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