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Individual

JACOB IRION RICHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 873-2200
Mailing address
131 CINCLARE DR, THIBODAUX, LA 70301-8083
(985) 447-4102

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP05864
LA

Other

Enumeration date
07/23/2009
Last updated
02/20/2012
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