Individual
ALFONSO OLIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2100 COLLEGE DR, APT. 53, BATON ROUGE, LA 70808-1861
(225) 614-8801
Mailing address
PO BOX 14083, BATON ROUGE, LA 70898-4083
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7793
LA
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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