Individual
LADARIUS D EALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 KYLE ST, NATCHITOCHES, LA 71457-3686
(318) 461-0790
Mailing address
102 KYLE ST, NATCHITOCHES, LA 71457-3686
(318) 461-0790
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
101YM0800X
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
LA
Enumeration date
12/21/2015
Last updated
12/21/2015
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