Individual
ZITA LUNA-BANIQUED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1585 THIRD ST., BAYNE JONES ACH, FORT POLK, LA 71459-5110
(337) 531-3074
(337) 531-3709
Mailing address
1605 AMOUR DR, LEESVILLE, LA 71446-5212
(337) 238-9317
(337) 531-3709
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
A37780
CA
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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