Organization
LAFAYETTE ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN R. MOORE C.O., B.O.C. (OWNDER)
(337) 232-7647
Entity
Organization
Contact information
Practice address
500 SAINT LANDRY ST, LAFAYETTE, LA 70506-4626
(337) 232-7647
(337) 232-4021
Mailing address
500 SAINT LANDRY ST, LAFAYETTE, LA 70506-4626
(337) 232-7647
(337) 232-4021
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CO003825
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316504
—
LA
Enumeration date
07/05/2005
Last updated
08/22/2020
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