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Individual

IRISH TANGSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2116 N BOLTON AVE, ALEXANDRIA, LA 71303-4405
(318) 441-0200
Mailing address
4732 NATCHEZ ST, ALEXANDRIA, LA 71302-4507

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30004089
LA

Other

Enumeration date
11/13/2024
Last updated
11/13/2024
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