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Individual

JUAN MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1109 CARTER ST, SUITE 10, VIDALIA, LA 71373-3227
(318) 336-4700
Mailing address
1109 CARTER ST, SUITE 10, VIDALIA, LA 71373-3227
(318) 336-4700

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/01/2017
Last updated
03/01/2017
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