Individual
CLYDE R SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4510 SUGAR HOLLOW LANE, ADDIS, LA 70710-2203
(225) 733-6695
Mailing address
4510 SUGAR HOLLOW LANE, ADDIS, LA 70710-2203
(225) 733-6695
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
LA
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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