Individual
DWAYNE OLIVER JETER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 769-3000
Mailing address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 769-3000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08020
LA
Other
Enumeration date
11/01/2014
Last updated
11/01/2014
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