Individual
RONALD DEWEY STAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
17094 AIRLINE HWY, PRAIRIEVILLE, LA 70769-3400
(225) 677-8400
(225) 677-8484
Mailing address
17094 AIRLINE HWY, PRAIRIEVILLE, LA 70769-3400
(225) 677-8400
(225) 677-8484
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
A10660
LA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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