Individual
MR. JOSEPH R. DESAULNIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
RR 2 BOX 169-G, GRAYROCK PROFESSIONAL PARK, LEWISBURG, WV 24901-9316
(304) 645-1706
(304) 645-4085
Mailing address
420 W PINHOOK RD, SUITE A, LAFAYETTE, LA 70503-2131
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000766
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006155
—
WV
Enumeration date
01/08/2007
Last updated
07/09/2007
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