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Individual

MICHAEL FAZENDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3419 SAINT CLAUDE AVE, NEW ORLEANS, LA 70117-6144
(504) 279-6414
Mailing address
431 CENTRAL AVE, JEFFERSON, LA 70121-3407

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1887
LA

Other

Enumeration date
05/03/2013
Last updated
05/03/2013
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