Individual
MR. LEE OTIS MARYLAND SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 W GREEN ST, HAMMOND, LA 70403-4807
(985) 351-8865
(775) 254-9828
Mailing address
119 W GREEN ST, HAMMOND, LA 70403-4807
(985) 351-8865
(775) 254-9828
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
HI.0552691
LA
Other
Enumeration date
02/08/2008
Last updated
02/08/2008
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