Individual
JA'JUAN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
42573 PLEASANT RIDGE ROAD EXT, PONCHATOULA, LA 70454-4764
(318) 415-8872
Mailing address
137 PENN MILL LAKES BLVD, COVINGTON, LA 70435-0574
(318) 415-8872
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
558499
LA
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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