Individual
MARY BREAUX RODRIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4912 HIGHWAY 1, RACELAND, LA 70394-2559
(985) 532-2387
Mailing address
4912 HIGHWAY 1, RACELAND, LA 70394-2559
(985) 532-2387
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200629
LA
Other
Enumeration date
08/21/2013
Last updated
05/20/2016
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