Individual
MATTHEW QUINN EZERNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4080 NELSON RD STE 500, LAKE CHARLES, LA 70605-2440
(337) 494-7546
Mailing address
2923 SUMMER PLACE DR, SULPHUR, LA 70663-0758
(337) 309-0925
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11530
LA
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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