Individual
KIM N POLUDNIANYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1717 OAK PARK BLVD FL 3, LAKE CHARLES, LA 70601
(337) 494-4900
(337) 494-4936
Mailing address
PO BOX 122165 DEPT 2165, DALLAS, TX 75312-2165
(337) 494-4900
(337) 494-4936
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
320010
LA
Other
Enumeration date
06/25/2007
Last updated
08/26/2019
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