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Organization

LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS OF LOUISIANA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD R GINGRAS (PRESIDENT)
(336) 397-2165
Entity
Organization

Contact information

Practice address
3113 LAKE ST, LAKE CHARLES, LA 70601-8337
(337) 477-9102
(337) 477-9104
Mailing address
PO BOX 24128, WINSTON SALEM, NC 27114-4128
(336) 397-2165
(336) 397-2167

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1651681
LA
Enumeration date
09/20/2006
Last updated
05/06/2014
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