Individual
MS. MARIETTA ARLENE SEPULVADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
333 LEE DR, BATON ROUGE, LA 70808-4980
(225) 490-3424
Mailing address
39444 HESS RD, DENHAM SPRINGS, LA 70706-0278
(225) 490-3424
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4892
LA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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