Individual
MS. SANDY TILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 JOE JOHNSON RD, HOLDEN, LA 70744-8006
(225) 777-4204
(225) 777-4205
Mailing address
200 JOE JOHNSON RD, HOLDEN, LA 70744-8006
(225) 777-4204
(225) 777-4205
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
2203781168
LA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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