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Individual

JOHN ALLEN LOUSTALOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
PO BOX 1894, MORGAN CITY, LA 70381-1894
(337) 940-1139
Mailing address
PO BOX 1894, MORGAN CITY, LA 70381-1894
(337) 940-1139

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
011086626
LA

Other

Enumeration date
09/09/2024
Last updated
09/09/2024
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