Individual
MR. JACK WILLIAM PLOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1517 HURON AVE, METAIRIE, LA 70005-1237
(985) 707-2829
Mailing address
1517 HURON AVE, METAIRIE, LA 70005-1237
(985) 707-2829
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
LA
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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