Individual
LAURA LEIGH THOMPSON BUISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
900 N CANAL BLVD, THIBODAUX, LA 70301-8096
(985) 446-3226
Mailing address
900 N CANAL BLVD, THIBODAUX, LA 70301-8096
(985) 446-3226
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1596-629T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07135054
—
MS
05
—
2119401
—
LA
Enumeration date
08/04/2010
Last updated
09/17/2012
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