Individual
DR. JASON RANDALL SPOONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, RN
Contact information
Practice address
4112 LAKE ST STE 600, LAKE CHARLES, LA 70605-4306
(337) 304-8034
Mailing address
2665 NEWBERRY STATION DR, LAKE CHARLES, LA 70611-3984
(337) 302-9034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09016R
LA
Other
Enumeration date
12/11/2017
Last updated
12/11/2017
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