Individual
RONALD RICKEY POULAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
282 LAWRENCE ST, BREAUX BRIDGE, LA 70517-4206
(337) 247-5248
Mailing address
282 LAWRENCE ST, BREAUX BRIDGE, LA 70517-4206
(337) 247-5248
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/29/2018
Last updated
12/29/2018
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