Individual
MY DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2741 FAIRFIELD AVE, GRETNA, LA 70056-7733
(504) 214-1888
Mailing address
2741 FAIRFIELD AVE, GRETNA, LA 70056-7733
(504) 214-1888
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
343245
LA
Other
Enumeration date
10/24/2025
Last updated
10/24/2025
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