Individual
CHARLES FREDERICK PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
216 NORTH SECOND ST, AMITE, LA 70422-0398
(985) 748-7878
(985) 748-2837
Mailing address
PO BOX 398, AMITE, LA 70422-0398
(985) 748-7878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1013
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1986186
—
LA
Enumeration date
03/14/2006
Last updated
12/27/2007
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