Individual
LAWRENCE EDWIN JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 W PINHOOK RD STE 310, LAFAYETTE, LA 70503-2448
(504) 452-0079
Mailing address
1001 W PINHOOK RD STE 310, LAFAYETTE, LA 70503-2448
(504) 452-0079
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
LA
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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