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Individual

KYLE O HOTARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
115 JOHNNY DUFRENE DR, RACELAND, LA 70394-2611
(985) 532-9662
Mailing address
310 N MOSS DR, HOUMA, LA 70360-3955
(985) 804-3194

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11731
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1820261
LA
Enumeration date
06/08/2006
Last updated
03/29/2010
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