Individual
MRS. EMMA W BOLLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6703 AMBASSADOR CAFFERY PKWY STE 2, BROUSSARD, LA 70518-5283
(337) 948-1766
(337) 948-1768
Mailing address
123 COUNTRY LIVING DR, LAFAYETTE, LA 70507-2108
(337) 501-5279
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
324303
LA
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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