Individual
MARTHA A CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9211 COLLINSTON RD, BASTROP, LA 71220-8703
(318) 351-0850
(318) 239-3704
Mailing address
9211 COLLINSTON RD, BASTROP, LA 71220-8703
(318) 351-0850
(318) 239-3704
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
870290
LA
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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