Individual
LARONDA LYNN DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 SHADY LN, MONROE, LA 71203-2228
(318) 512-9619
(318) 323-3570
Mailing address
135 SHADY LN, MONROE, LA 71203-2228
(318) 512-9619
(318) 323-3570
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1926787
—
LA
Enumeration date
06/03/2013
Last updated
06/03/2013
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