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Individual

MRS. STACY LYNETTE KOLMANSBERGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
37043 OAK HAVEN DR, DENHAM SPRINGS, LA 70706-0498
(225) 620-3320
(225) 667-4069
Mailing address
37043 OAK HAVEN DR, DENHAM SPRINGS, LA 70706-0498
(225) 620-3320
(225) 667-4069

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
A808590
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34390000X
LA
Enumeration date
09/03/2015
Last updated
09/03/2015
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