Individual
CAROLYN VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 MEADOW FARM DR., INSIDE OF COSTCO, LAFAYETTE, LA 70508
(337) 541-7040
(337) 541-7041
Mailing address
6000 JOHNSTON ST, APT 212, LAFAYETTE, LA 70503-5645
(225) 405-3792
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1794-728AT
LA
Other
Enumeration date
07/29/2015
Last updated
04/19/2016
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