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Individual

WENDY LIVOUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4901 WINNEBAGO ST, BATON ROUGE, LA 70805-6170
(225) 288-0938
(225) 778-5664
Mailing address
4901 WINNEBAGO ST, BATON ROUGE, LA 70805-6170
(225) 288-0938
(225) 778-5664

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0044884556
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81-2599339
FEDERAL TAX ID
LA
Enumeration date
05/13/2016
Last updated
05/13/2016
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