Individual
STEVEN MORTRUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
127 W BROAD ST STE 850, LAKE CHARLES, LA 70601-4394
(337) 310-8500
Mailing address
21342 PARKER DRIVE, MANDEVILLE, LA 70471-7610
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
341189
LA
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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