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Individual

MRS. LORIE O WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5854 HIGHWAY 77, FORDOCHE, LA 70732
(225) 637-2178
(225) 637-2185
Mailing address
PO BOX 178, FORDOCHE, LA 70732-0178
(225) 637-2178
(225) 637-2185

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
87198
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1562122
LA
Enumeration date
07/07/2008
Last updated
07/07/2008
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