Individual
OWEN M GAUTHIER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12371 HIGHWAY 90, SUITE D, LULING, LA 70070-5114
(985) 331-1001
(985) 331-1005
Mailing address
12371 HIGHWAY 90, SUITE D, LULING, LA 70070-5114
(985) 331-1001
(985) 331-1005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08567
LA
Other
Enumeration date
11/29/2013
Last updated
11/29/2013
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