Individual
IESHA MICHELLE BRIDGEWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1134 BARROW ST, HOUMA, LA 70360-5608
(985) 217-2006
Mailing address
210 EVELYN AVE, HOUMA, LA 70363-5434
(985) 217-2006
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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