Individual
ELIZABETH KONZELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2657 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-6435
(985) 626-5849
Mailing address
5750 JOHNSTON ST STE 502, LAFAYETTE, LA 70503-5334
(337) 417-9200
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA715
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801541482
DRIVER'S LICENSE
MS
Enumeration date
08/22/2022
Last updated
08/22/2022
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