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Individual

REUBEN E AIMIENOHOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1021 WILBER CT APT B, GRETNA, LA 70056-8022
(504) 287-1021
Mailing address
1021 WILBER CT APT B, GRETNA, LA 70056-8022
(504) 287-1021

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
02/24/2018
Last updated
02/24/2018
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  • EDI platform