Individual
LINDA M SIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12371 HIGHWAY 90, SUITE D, LULING, LA 70070-2371
(985) 331-1001
(985) 331-1005
Mailing address
12371 HIGHWAY 90, SUITE D, LULING, LA 70070-5114
(985) 331-1001
(985) 331-1005
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A7161
LA
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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