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Individual

MR. PHILLIP ANTHONY LIRETTE I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
2007 CLEARVIEW PKWY, METAIRIE, LA 70001-2404
(504) 456-9296
Mailing address
3901 N I 10 SERVICE RD W APT B212, METAIRIE, LA 70002-6804

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA8611
LA

Other

Enumeration date
12/13/2017
Last updated
12/13/2017
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