Individual
TAMMANY BOUTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT(R)
Contact information
Practice address
16218 W LA HWY 700, KAPLAN, LA 70548-6449
(337) 652-3349
Mailing address
16218 W LA HWY 700, KAPLAN, LA 70548-6449
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
12769
LA
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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