Individual
RAINNIER DWIGHT MIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
3444 MASONIC DR, ALEXANDRIA, LA 71301-3615
(318) 473-9556
(318) 441-8329
Mailing address
3444 MASONIC DR, ALEXANDRIA, LA 71301-3615
(318) 473-9556
(318) 441-8329
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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