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Individual

KENNETH QUICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
233 ST ANN DR, SUITE 4, MANDEVILLE, LA 70471-3395
(985) 727-3936
(985) 727-3525
Mailing address
233 ST ANN DR, STE 4, MANDEVILLE, LA 70471-3395
(985) 727-3936
(985) 727-3525

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PD117R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1925560
LA
Enumeration date
06/19/2006
Last updated
06/11/2014
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