Individual
KEITH M MENARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4448 LAKE ST, LAKE CHARLES, LA 70605-4312
(337) 478-4733
(337) 478-4734
Mailing address
4448 LAKE ST, LAKE CHARLES, LA 70605-4312
(337) 478-4733
(337) 478-4734
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1369
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1116289
—
LA
Enumeration date
06/09/2006
Last updated
04/04/2012
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