Individual
TAMIKO CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4042 CHOCTAW RD, BRUSLY, LA 70719-2303
(225) 202-5276
Mailing address
4042 CHOCTAW RD, BRUSLY, LA 70719-2303
(225) 202-5276
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
005474901
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2190466
—
LA
Enumeration date
01/19/2016
Last updated
01/19/2016
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