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Individual

AMY SALVANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LOTR

Contact information

Practice address
125 LOUISE DR, MANDEVILLE, LA 70448-3437
(985) 674-3998
(985) 674-3998
Mailing address
125 LOUISE DR, MANDEVILLE, LA 70448-3437
(985) 674-3998
(985) 674-3998

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
Z11574
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1-47381-2
LA
Enumeration date
03/25/2007
Last updated
07/08/2007
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