Individual
DERRICK MONTRELLE OATIS, JR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1761 N 19TH ST, MONROE, LA 71201-4554
(318) 509-8073
(318) 703-5765
Mailing address
1761 N 19TH ST, MONROE, LA 71201-4554
(318) 509-8073
(318) 703-5765
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/22/2022
Last updated
12/22/2022
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