Individual
BANYON L TUMINELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
14159 HIGHWAY 16, AMITE, LA 70422-4603
(985) 747-3422
(985) 747-3424
Mailing address
PO BOX 971, AMITE, LA 70422-0971
(985) 747-3422
(985) 747-3424
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02691
LA
Other
Enumeration date
05/24/2006
Last updated
11/28/2007
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