Individual
ODAY J LAVERGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
124 KINGS COUNTRY VILLAGE, PINEVILLE, LA 71360
(318) 443-5278
Mailing address
P.O. BOX 12415, ALEXANDRIA, LA 71315
(318) 443-5278
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00332
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1989177
—
LA
Enumeration date
10/03/2006
Last updated
07/08/2007
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