Individual
KEVIN PAUL LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST/CSFA
Contact information
Practice address
301 VILLAGE PARK DR, MAURICE, LA 70555-4441
(337) 517-8738
Mailing address
301 VILLAGE PARK DR, MAURICE, LA 70555-4441
(337) 517-8738
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
91262
LA
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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