Individual
JASON ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 LONGFELLOW DR, LAFAYETTE, LA 70503-6611
(337) 230-9266
Mailing address
120 LONGFELLOW DR, LAFAYETTE, LA 70503-6611
(337) 230-9266
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
37-1930197
LA
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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