Individual
MISS LAURA FRANCES BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2647 S SAINT ELIZABETH BLVD, GONZALES, GONZALES, LA 70737-5021
(225) 647-8511
(225) 644-5213
Mailing address
2647 S SAINT ELIZABETH BLVD, GONZALES, GONZALES, LA 70737-5021
(225) 647-8511
(225) 644-5213
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200693
LA
Other
Enumeration date
04/10/2012
Last updated
01/13/2021
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