Individual
JOHN WILLIAM SULLIVAN CHETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T
Contact information
Practice address
311 W 21ST AVE, COVINGTON, LA 70433-3153
(985) 898-2707
Mailing address
108 DEVON DR, MANDEVILLE, LA 70448-3406
(985) 966-9651
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
8448
LA
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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