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Individual

JAMMIE MARIE WEBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
918 GASSEN ST, LULING, LA 70070-4316
(504) 708-8548
(504) 475-5861
Mailing address
918 GASSEN ST, LULING, LA 70070-4316
(504) 708-8548
(504) 475-5861

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
005139215
LA

Other

Enumeration date
01/16/2017
Last updated
01/16/2017
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