Individual
MR. DANIEL LEE RICHARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 N CHERRY ST, LAKE CHARLES, LA 70601-2671
(337) 304-5305
(337) 376-5244
Mailing address
1525 12TH ST, LAKE CHARLES, LA 70601-6471
(337) 304-5305
(337) 376-5244
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
6431933
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
473357230
FEDERAL
LA
Enumeration date
05/31/2016
Last updated
05/31/2016
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