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Individual

WILLIE PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10782 N HARRELLS FERRY RD STE A, BATON ROUGE, LA 70816-8227
(225) 346-1700
Mailing address
17253 DEER LAKE AVE, BATON ROUGE, LA 70816-1715
(225) 337-9791

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
44892
LA

Other

Enumeration date
02/21/2017
Last updated
02/21/2017
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