Individual
JOSHUA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1505 BESSON LN, ST. GABRIEL, LA 70780
(225) 227-7419
Mailing address
1505 BESSON LN, SUNSHINE, LA 70780
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343900000X
—
LA
Enumeration date
07/31/2014
Last updated
07/31/2014
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