Individual
MR. COLIN RADER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
160 SAN ANTONIO AVE, MANY, LA 71449-3009
(318) 353-3412
(318) 353-3413
Mailing address
160 SAN ANTONIO AVE, MANY, LA 71449-3009
(318) 353-3412
(318) 353-3413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200765
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2377698
—
LA
Enumeration date
11/18/2009
Last updated
10/28/2021
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