Individual
TINA MAYO WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18017 GLEN PARK DR, BATON ROUGE, LA 70817-9583
(225) 588-6292
(225) 751-0171
Mailing address
18017 GLEN PARK DR, BATON ROUGE, LA 70817-9583
(225) 588-6292
(225) 751-0171
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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