Individual
RYAN KEOGH PALERMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1717 OAK PARK BLVD FL 3, LAKE CHARLES, LA 70601-8990
(337) 494-4900
(337) 494-4947
Mailing address
PO BOX 122165 DEPT 2165, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
340419
LA
Other
Enumeration date
03/04/2024
Last updated
06/11/2024
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