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Individual

ATHAN JOSEPH JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1097 S FLANNERY RD, BATON ROUGE, LA 70815-6920
(504) 957-0001
Mailing address
14741 BRIGHTVIEW CT, BATON ROUGE, LA 70819-4012
(504) 957-0001

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
LA

Other

Enumeration date
08/27/2018
Last updated
08/27/2018
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