Individual
MR. BRYAN S JEANFREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2495 SHREVEPORT HWY #71, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
2495 SHREVEPORT HWY # 71, PINEVILLE, LA 71360-4044
(318) 473-0010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1238-038AT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880131
—
MS
05
—
1182214
—
LA
Enumeration date
12/08/2006
Last updated
02/15/2024
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