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Individual

TROY MIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOT, LOTR

Contact information

Practice address
15618 COUNTRY RD, GREENWELL SPRINGS, LA 70739-3509
(225) 614-5612
Mailing address
15618 COUNTRY RD, GREENWELL SPRINGS, LA 70739-3509

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OTT200870
LA

Other

Enumeration date
10/28/2015
Last updated
10/28/2015
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