Individual
KASEY S FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 LONGWOOD DR, THIBODAUX, LA 70301-8027
(985) 778-3148
(800) 786-0683
Mailing address
101 LONGWOOD DR, THIBODAUX, LA 70301-8027
(985) 778-3148
(800) 786-0683
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
1642
—
Other
Enumeration date
06/25/2014
Last updated
12/11/2018
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