Individual
MS. TAWANNA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12750 JOYNTON ROAD, FLUKER, LA 70436
(985) 514-8869
Mailing address
PO BOX 108, FLUKER, LA 70436-0108
(985) 514-8869
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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