Organization
READY SET GEAUX THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIE MOORE BANGE MOT, LOTR (OWNER)
(318) 286-7650
Entity
Organization
Contact information
Practice address
522 OIL FIELD RD, ELM GROVE, LA 71051-7909
(318) 286-7650
Mailing address
522 OIL FIELD RD, ELM GROVE, LA 71051-7909
(318) 286-7650
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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