Individual
MEREDITH BOUSTANY MANAFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 PHOENIX DR, ABBEVILLE, LA 70510-2396
(337) 898-3700
(337) 898-3702
Mailing address
604 N ACADIA RD STE 101, THIBODAUX, LA 70301-4897
(985) 446-5079
(985) 447-2497
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
303565
LA
Other
Enumeration date
09/07/2016
Last updated
03/14/2024
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