Individual
MR. THAD ELTER LEBOEUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3036
(337) 494-2181
Mailing address
1511 COTTAGE LN, LAKE CHARLES, LA 70601-5350
(337) 274-4547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09410
LA
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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