Individual
ROLANDRA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
536 JUNG BLVD, MARRERO, LA 70072-1012
(504) 816-0292
Mailing address
536 JUNG BLVD, MARRERO, LA 70072-1012
(504) 816-0292
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
006627995
LA
Other
Enumeration date
03/12/2022
Last updated
03/12/2022
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