Individual
RICCARDO NEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1109 CARTER ST, VIDALIA, LA 71373-3227
(318) 336-4700
Mailing address
1109 CARTER ST, VIDALIA, LA 71373-3227
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1561444
—
LA
Enumeration date
01/06/2016
Last updated
01/06/2016
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