Individual
WANDA CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PROSTHETIC SPECIALIS
Contact information
Practice address
530 PROVIDENCE ST, NEW IBERIA, LA 70560-4431
(337) 577-2331
Mailing address
804 ANDERSON ST, NEW IBERIA, LA 70560-4138
(337) 577-2331
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
865310909
LA
1744P3200X
Prosthetics Case Management
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Other
Enumeration date
09/19/2022
Last updated
02/24/2023
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