Individual
DR. GARY JAMES AVALLONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
911 TECH DRIVE, RUSTON, LA 71270-0701
(318) 251-9095
(318) 251-1705
Mailing address
144 FOX RUN, WEST MONROE, LA 71291-8137
(318) 397-2041
(318) 396-8936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3151T
TX
152W00000X
Optometrist
Primary
927-032T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346870
—
LA
Enumeration date
05/09/2006
Last updated
09/18/2008
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