Individual
MR. RAYLEN NEIL MIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1018 HARDING ST STE 205D, LAFAYETTE, LA 70503-2400
(337) 366-1501
Mailing address
112 CANARY LN, DUSON, LA 70529-3827
(337) 366-1501
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10066
LA
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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