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Individual

KAYLA FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8846 GOV NICHOLS DR, BATON ROUGE, LA 70811-2505
(225) 938-3171
(225) 208-1359
Mailing address
8846 GOV NICHOLS DR, BATON ROUGE, LA 70811-2505
(225) 938-3171
(225) 208-1359

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
0008159768
LA

Other

Enumeration date
03/26/2012
Last updated
03/26/2012
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