Individual
MS. COURTNEY VICE HABETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1119 N MAIN ST, SAINT MARTINVILLE, LA 70582-3513
(337) 394-7774
(337) 394-8015
Mailing address
401 YOUNGSVILLE HWY, SUITE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
(337) 330-0059
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200121
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407208
—
LA
Enumeration date
03/05/2007
Last updated
09/10/2016
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