Individual
COLLIN DESANDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
164 KLEINPETER DR, THIBODAUX, LA 70301-6802
(985) 859-4962
Mailing address
164 KLEINPETER DR, THIBODAUX, LA 70301-6802
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
207038
LA
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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