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Individual

MR. COREY CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1947 78TH AVE, BATON ROUGE, LA 70807-5516
(225) 286-6220
Mailing address
1934 78TH AVE, BATON ROUGE, LA 70807-5515
(225) 239-1906

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
009252396
LA

Other

Enumeration date
01/17/2026
Last updated
01/17/2026
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